Volume 26, Issue 128, October 2022

Comparing the effectiveness of treatment with radio frequency denervation, cryoablation and endoscopic debridement of the facet joints

Rapčanová Simona¹, Rapčan Róbert¹, Witkovsky Viktor², Kočan Ladislav^3,4, Poliak Ľubomír⁵, Lenčéš Peter⁵, Mláka Juraj⁴, Griger Martin⁵, Burianek Miroslav⁶, Vašková Janka^7♦

¹Euro Pain Clinics, Nahradbách 94/3, 085 01 Bardejov, Slovak Republic
²Institute of Measurement Science, Slovak Academy of Sciences, Dúbravská cesta 9, 841 04 Bratislava, Slovak Republic
³Clinic of Anaesthesiology and Intensive Care Medicine, East Slovak Institute of Cardiovascular Disease, Ondavská 8, 040 11 Košice, Slovak Republic
⁴EuroPainClinics, Poliklinika Terasa, Toryská 1, 040 11 Košice, Slovak Republic
⁵Europainclinics, Kominárska 21/5, 831 04 Bratislava – Nové mesto, Slovak Republic
⁶EuroPainClinics, Starochodovská 1750/91, 149 00 Prague 4, Czech Republic
⁷Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Tr. SNP 1, 040 11, Košice, Slovak Republic

^♦Corresponding author
Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Tr. SNP 1, 040 11, Košice, Slovak Republic

ABSTRACT

Background: One of the main causes of chronic lower back pain is lumbar facet syndrome (LFS). It develops due to the damage of the facet joints and subsequent irritation of the adjacent sensory nerves. The diagnosis of LFS is based on comprehensive clinical examinations of the patient, evaluation of imaging diagnostic studies and nerve blockades under X-ray guidance. Methods: In a prospective observational multicenter clinical trial NCT04684303, we compared the clinical outcomes of three groups of patients who underwent denervation procedures of the zygapophyseal joints with either cryoablation therapy (n=48), radio frequency denervation (n=18) or endoscopic facet debridement (n=21). Results: Evaluation of changes in pain perception and quality of life were made by comparing the quality of life scale (EQ-VAS), and the numerical pain scale, which showed a statistically significant improvement (p<0.001) in 3 months follow up after procedure. Conclusion: Study showed an equivalent effectiveness of endoscopic facet joint debridement compared to radio frequency denervation and cryoablation of the dorsal nerve branch, with persistent outcome.

Keywords: cryoablation, endoscopic facet debridement, facet joint, lower back pain, lumbar facet syndrome

Medical Science, 2022, 26, ms435e2469

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DOI: https://doi.org/10.54905/disssi/v26i128/ms435e2469

Published: 31 October 2022