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| LI Zhenzhou,HOU Shuxun,SHANG Weilin.Endoscopic dorsal rhizotomy for chronic lumbar zygapophyseal joint originated pain[J].Chinese Journal of Spine and Spinal Cord,2013,(3):215-221. |
| Endoscopic dorsal rhizotomy for chronic lumbar zygapophyseal joint originated pain |
| Received:October 22, 2012 Revised:November 30, 2012 |
| English Keywords:Chronic low back pain Medial branch neurotomy Endoscopic Rhizotomy Lumbar zygapophyseal joint originated pain Facet syndrome |
| Fund:首都临床特色应用研究基金资助项目（编号：Z121107001012097） |
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| English Abstract: |
| 【Abstract】 Objectives: To prospectively investigate the clinical outcome of endoscopic dorsal rhizotomy(endoscopic lumbar medial branch neurotomy) for chronic lumbar zygapophyseal joint originated pain. Methods: From April 2011 to October 2011, 58 patients with chronic low back pain were determined as chronic lumbar zygapophyseal joint originated pain by more than 80% pain relief after controlled differential(double) medial branch block(MBB) with lidocaine and bupivacaine respectively. 45 cases underwent endoscopic dorsal rhizotomy(operation group), while 13 cases underwent conservative treatment, including NSAIDs, physical therapy and recognition therapy(conservative group). The VAS scores of low back pain and referred pain were recorded at each time point, including VAS scores before MBB, after MBB, 1d, 3 months, 6 months and 12 months postoperatively. MacNab scores were evaluated at 12 month follow-up. The clinical outcomes of endoscopic dorsal rhizotomy and conservative treatment were analyzed and compared. Results: In operation group, postoperative VAS scores of low back pain and referred pain significantly decreased compared with those before MBB(P<0.05), which showed no significant difference with those after MBB(P>0.05). In conservative group, VAS scores of low back pain and referred pain after treatment decreased significantly compared with that before MBB(P<0.05) and were significantly higher than those after MBB(P<0.05). The rate of pain relief in operation group was significantly higher than that in conservative group(P<0.01). MacNab scores of 1 year follow-up included 27 excellent, 17 good, 1 fair in operation group and 6 fair, 7 poor in conservative group respectively. Conclusions: Endoscopic dorsal rhizotomy is safe and effective for chronic lumbar zygapophyseal joint originated pain, which is superior over conservative treatment. |
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