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Abstract
The high incidence of degenerative-dystrophic spinal cord injury with low effectiveness of spondylarthrosis therapy makes relevant the study on the treatment of low lumbar pain syndrome, caused mainly by spondyloarthrosis, with an innovative minimally invasive method of high-frequency denervation of the facet joints in combination with periarticular injection of a local anesthetic and a steroidal.
Purpose of the study. Determine the effectiveness of the of radiofrequency denervation of the facet joints in combination with the periarticular injection of a local anesthetic and a steroidal to eliminate the pain syndrome in patients with lower lumbar pain syndrome with the predomination of spondyloarthrosis, taking into account early and long-term results of treatment.
Material and methods. of 136 patients (73 men and 63 women aged 44 to 81 years) with a lower lumbar pain, where spondyloarthrosis dominated, in which only radiofrequency denervation of the facet joints was performed. The analysis of early and long-term results of treatment of 78 patients (37 men and 41 women aged from 51 to 79 years) with lower lumbar pain syndrome in which the leading clinical sign was arthrosis of arched joints that formed the main group, high-frequency denervation of the facet joints Using RFG-1A/RFG-1B device from Radionics in combination with periarticular injection of a local anesthetic and a steroidal. Assessment of the pain syndrome was carried out four times – in the preoperative and postoperative periods (during the week), in 3 months and in 1 year after treatment. The visual analogue scale (VAS) of pain and the Oswestry index of disability index were used. The control group consisted of 136 patients (73 men and 63 women aged 44 to 81 years) with a lower lumbar pain, where spondyloarthrosis dominated, in which only radiofrequency denervation of the facet joints was performed. Study results. Relatively better results in the early period were obtained in the group of patients who underwent radio frequency denervation of the facet joints in combination with the periarticular injection of a local anesthetic and a steroidal. Whereas in the distant period (1 year after treatment), there is no such difference between the primary and control groups.
Conclusion. The results of treatment in the early and late periods after treatment testify to the efficacy and safety of both radiofrequency denervation of the facet joints and the radiofrequency denervation of the facet joints in combination with periarticular injection of the local anesthetic and steroidal in patients with low lumbar pain syndrome dominated by spondyloarthrosis. Both methods can be recommended for inclusion in the treatment algorithm for facet syndrome with ineffectiveness of conservative treatment.
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