The Internet Journal of Minimally Invasive Spinal Technology™ ISSN: 1937-8254

The Internet Journal of Minimally Invasive Spinal Technology is the official online journal of ISMISS/SICOT (International Society of Minimally Invasive Spinal Surgery, affiliate of SICOT) and AAMISMS (American Academy of Minimally Invasive Spine Surgery and Medicine)

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Lumbar And Cervical Facet Joint Denervation With Laser

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Sri Kantha MD

Citation: S. Kantha : Lumbar And Cervical Facet Joint Denervation With Laser. The Internet Journal of Minimally Invasive Spinal Technology. 2009 Supplement II - to IJMIST Vol III No 4

Abstract

Facet joint arthritis is a common cause of disabling neck and low back pain. Currently the treatment options include facet joint blocks, radiofrequency and laser facet rhizotomy, and spinal fusion in severe cases. The results of facet joint blocks with steroids and local analgesics are temporary. Radiofrequency rhizotomy of cervical and lumbar facet joints has been implemented over the past 25 years. From my clinical experience, the results of radiofrequency facet rhizotomy are variable from 9-83%. Lasers have been used in disc decompression since 1991 with excellent results. This has prompted us to use laser on intractable cervical and lumbar facet joint arthritis pain and facet joint mediated pain post discectomy. Laser is widely employed in various surgical specialties for its precision in thermocoagulation. Laser has the advantage that a relatively larger area in the vicinity of the probe undergoes thermocoagulation in contrast to a radiofrequency probe. We have used this procedure on patients with intractable facet joint mediated pain since 1993. Many of our patients had multiple open spinal surgeries and also endoscopic discectomies. Their radiculopathy had improved, but these patients continued to experience paraspinal neck and back pain, and referred pain including headaches, suprascapular discomfort, and pain radiating to the posterior thigh. Some patients who had failed or experienced short lasting relief following radiofrequency denervation, underwent laser facet joint denervation, with complete and long lasting relief. Percutaneous laser facet joint denervation is a technique which can be used in intractable pain secondary to cervical and lumbar facet joint arthritis, and post-discectomies. This is a minimally invasive procedure with good to excellent success rate. Cervical and lumbar facet joint denervation by laser-assisted technique is performed using a cannula to approach the facet joints. A HO: YAG laser straight firing probe is inserted through the cannula and laser heat is applied at 10 Hz, 5 watts to selectively denervate the facet joint. Every effort is made to denervate the joint yet preserve the capsule of the joint. From my personal experience, the results of laser denervation are more rewarding than radiofrequency lesioning for denervation of cervical and lumbar facet joints causing mechanical neck and low back pain.

This article was last modified on Fri, 03 Jul 09 14:16:47 -0500

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	The Internet Journal of Minimally Invasive Spinal Technology™ ISSN: 1937-8254 \| Home \| Editors \| Current Issue \| Archives \| Instructions for Authors \| Disclaimer \| Share with others \| The Internet Journal of Minimally Invasive Spinal Technology is the official online journal of ISMISS/SICOT (International Society of Minimally Invasive Spinal Surgery, affiliate of SICOT) and AAMISMS (American Academy of Minimally Invasive Spine Surgery and Medicine) Lumbar And Cervical Facet Joint Denervation With Laser Read printer friendly Subscribe in a reader Share with others Sri Kantha MD Citation: S. Kantha : Lumbar And Cervical Facet Joint Denervation With Laser. The Internet Journal of Minimally Invasive Spinal Technology. 2009 Supplement II - to IJMIST Vol III No 4 Abstract Facet joint arthritis is a common cause of disabling neck and low back pain. Currently the treatment options include facet joint blocks, radiofrequency and laser facet rhizotomy, and spinal fusion in severe cases. The results of facet joint blocks with steroids and local analgesics are temporary. Radiofrequency rhizotomy of cervical and lumbar facet joints has been implemented over the past 25 years. From my clinical experience, the results of radiofrequency facet rhizotomy are variable from 9-83%. Lasers have been used in disc decompression since 1991 with excellent results. This has prompted us to use laser on intractable cervical and lumbar facet joint arthritis pain and facet joint mediated pain post discectomy. Laser is widely employed in various surgical specialties for its precision in thermocoagulation. Laser has the advantage that a relatively larger area in the vicinity of the probe undergoes thermocoagulation in contrast to a radiofrequency probe. We have used this procedure on patients with intractable facet joint mediated pain since 1993. Many of our patients had multiple open spinal surgeries and also endoscopic discectomies. Their radiculopathy had improved, but these patients continued to experience paraspinal neck and back pain, and referred pain including headaches, suprascapular discomfort, and pain radiating to the posterior thigh. Some patients who had failed or experienced short lasting relief following radiofrequency denervation, underwent laser facet joint denervation, with complete and long lasting relief. Percutaneous laser facet joint denervation is a technique which can be used in intractable pain secondary to cervical and lumbar facet joint arthritis, and post-discectomies. This is a minimally invasive procedure with good to excellent success rate. Cervical and lumbar facet joint denervation by laser-assisted technique is performed using a cannula to approach the facet joints. A HO: YAG laser straight firing probe is inserted through the cannula and laser heat is applied at 10 Hz, 5 watts to selectively denervate the facet joint. Every effort is made to denervate the joint yet preserve the capsule of the joint. From my personal experience, the results of laser denervation are more rewarding than radiofrequency lesioning for denervation of cervical and lumbar facet joints causing mechanical neck and low back pain. This article was last modified on Fri, 03 Jul 09 14:16:47 -0500 This page was generated on Fri, 19 Mar 10 12:18:40 -0500, and may be cached.
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