Endoscopic Facet Joint Denervation on the Lumbar Spine: A Retrospective Analysis

Asian Spine J. 2023 Apr;17(2):382-391. doi: 10.31616/asj.2021.0150. Epub 2022 Dec 5.

Abstract

Study design: This single-center retrospective study analyzed patients with chronic low back pain (CLBP) who underwent endoscopic facet joint denervation (EFJD) between April 2018 and May 2019.

Purpose: This study was designed to investigate the effectiveness of EFJD in treating CLBP.

Overview of literature: CLBP is a challenging burden to healthcare systems worldwide. As up to 45% of cases originate from the lumbar facet joints, sufficient therapy strategies must be developed. EFJD offers a precise depiction of the dorsal medial ramus and the facet joint capsule.

Methods: In this study, 64 patients who underwent EFJD were included. The main outcome of interest was patients' Visual Analog Scale (VAS) pain score, which was recorded at 3-time points (i.e., before operation and 6 weeks and 12 months after surgery).

Results: EFJD effectively reduced the VAS pain scores by 58% in the short term (6 weeks) and 38% in the long term (12 months). Patients with isolated facet joint osteoarthritis benefited more (p <0.001).

Conclusions: EFJD is a good treatment alternative for CLBP originating from the facet joints, particularly in patients with isolated facet joint osteoarthritis. Moreover, this method can address not only the dorsal medial ramus but also the surrounding tissue (e.g., facet joint capsule, facet joint effusion, and osteophytes) as the origin of CLBP.

Keywords: Chronic low back pain; Dorsal medial ramus; Endoscopic facet joint denervation; Facet joint capsule; Facet joint effusion; Facet joint osteoarthritis.