Radiofrequency denervation of lumbar facet joints in the treatment of chronic low back pain

Low back pain is the most common pain syndrome and a global health burden. The etiology in most cases is multifactorial and the facet joints can be a source of low back pain. The facet joint is innervated by the medial branch of the dorsal ramus of the spinal nerve. Facet joint disturbances can be responsible for 10% to 50% of all cases of chronic lumbar pain. In the absence of predictive clinical or radiologic findings, nerve blocks are considered to be the best way of diagnosing presumed facet-mediated pain. Radiofrequency ablation to induce thermal necrosis of the facet neural fibers has been reported to provide significant pain reduction in patients for 6-12 months. A radiofrequency neurotomy is a type of injection procedure used to treat facet joint pain caused by arthritis or other degenerative changes, or from an injury. In this procedure, a heat lesion is created on certain nerves with the goal of interrupting the pain signals to the brain, thus eliminating pain. Medial Branch Neurotomy could be considered an option for patients suffering persistent axial and referred non-radicular leg pain unresponsive to less invasive conservative measures.