Abstract

Purpose of study is an increasing of prophylactic effectiveness of relapses after denervation of facet joints. Material and methods. In the group of patients (prospective investigation) we made diagnostic injection of facet joints and medial branch of spinal nerve in order to determine possible reinnervation. The result was indication fo redenervation of facet joints. After, we used the method of determination of medial branches localization of spinal nerves, which led the impulses from facet joints. The denervation of facet joints was made in 162 patients, 99 patients we examined retrospectively and 63-prospectively. They all were treated at the department of spine pathology of Sytenko Institute of Spine and joint pathology. In the group of patients (prospective examination) the method to determine, the localization of medial branch of posterior ramus of spinal nerves was performed. This method helps us to determine the optimal position of active point of needle-electrode relatively to medial branch of posterior ramus of spinal nerve due to it sensor electrostimulation. Topography of medial brauch of posterior ramus of varies in persons, thus generally accepted, staudant electrode poits can not coincide in some cases, because of that the nerve will not damaged entirely. Topography of medial braunch of posterior ramus of spinal nerve varies especially in patients with deformation of lumbar spine (spondylolistesis, scoliosis, kyphosis, hyperlordosis) and after operative treatment at posterior approach. As compared to retrospective results of pervious technologies for denervation of facet joints and prospective effectiveness of improved technologies for prophylactic of facet joint syndrome, we should mention that the results have been improveal significantly. Conclusion. Suggested method is effective at spondiloarthalgia after facet joint denervation in patient with lumbar spine deformation, also at spondiloarthralgia after sugerical treatment of lumbar spine due to posterior approach.