Percutaneous radiofrequency thermocoagulation of dorsal ramus branches as a treatment of “lumbar facet syndrome” - How I do it

Background: Low back pain is an extremely common and often chronic condition. In some cases, this is due to an irritative arthropathy of zygapophyseal joint involving the medial branch of the dorsal ramus of the spinal nerve. Percutaneous radiofrequency thermocoagulation appears to be the most effective treatment to date, among a range of different treatments. In this paper, the technique is described as performed at out institution. Methods: In supine position and under fluoroscopic control, a radiofrequency electrode is inserted into different articular zygapophyseal complexes to thermocoagulate ramifications of the medial branch of the dorsal primary ramus of the spinal nerve. Conclusions: Fluoroscopic-guided percutaneous radiofrequency thermocoagulation of dorsal rami branches is a safe and reliable technique for the treatment of lumbar facet syndrome. Careful selection of patients based on clinical presentation and positive anesthetic block test are key points for an optimum outcome.