Spine (Phila Pa 1976). 2022 Jul 1. doi: 10.1097/BRS.0000000000004392. Online ahead of print.
ABSTRACT
STUDY DESIGN: This was a single-center prospective randomized controlled study.
OBJECTIVE: To compare the efficacy of endoscopic facet joint denervation with that of the percutaneous technique in terms of pain, functional disability, and quality of life in patients with low back pain.
SUMMARY OF BACKGROUND DATA: Different controlled studies in patients with low back pain have shown short-term benefits from percutaneous facet joint denervation. Observational studies have demonstrated that endoscopic facet joint denervation may be more effective. As the superiority of the endoscopic technique has not been clearly demonstrated in previous studies, a prospective randomized controlled study was conducted.
METHODS: For this study, 40 patients with low back pain lasting more than 6 months duration and at least 50% pain reduction on the visual analog scale (VAS) after medial branch block under fluoroscopy, were assigned randomly to receive percutaneous or endoscopic facet joint denervation. The primary outcome was pain, as indicated by Visual Analog Scale (VAS). Secondary outcomes were functional disability, as assessed by the Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RDQ), and quality of life, as assessed by the Short Form Health Survey (SF-36).
RESULTS: After the intervention, the pain level decreased significantly in both groups (P<0.001); however, the effect was still significant in the endoscopic group and diminished to lower than the statistical significance in the percutaneous group after 12 months. The ODI and RDQ scores also improved significantly in both groups (P<0.001). However, the ODI and RDQ were significantly better (P<0.001) in the endoscopic group after 12 months. In the SF-36, we observed significant improvement in both groups 3 months after the intervention. The effect decreased after six months in the percutaneous group and was predominantly not demonstrable after 12 months, whereas in the endoscopic group there was still a strong significant improvement on all scales (P<0.001) after 12 months.
CONCLUSION: Percutaneous and endoscopic facet joint denervation reduced pain and improved functionality and quality of life. However, the effects decreased or disappeared in the percutaneous group after 12 months, whereas there was still a strong significant improvement in the endoscopic group.
PMID:35797653 | DOI:10.1097/BRS.0000000000004392
