EuroPainClinics Study IV – Radiofrequency denervation of facet joints

The EuroPainClinics®Study IV (EPCS IV) study is a prospective, observational, comparative study comparing changes in neurological status, evaluating algesiological scales in patients who will undergo an interventional minimally invasive procedure – radiofrequency denervation of lumbar facet joints.

Endoscopic rhizotomy – endoscopically visualized radiofrequency denervation of facet joints with assisted X-ray navigation.

Facet joint pain represents a significant proportion of the source of pain in patients with vertebrogenic algic syndrome. A typical symptom is a …  projection of pain in the back and legs. The cause of this pain is irritation of the medial branch of the dorsal branch of the nerve root through which the facet joint is innervated. Verification of pain consists of blocking the medial branch with a local anesthetic in several vertebral levels. If the test is positive, the patient is then indicated for radiofrequency denervation of the affected nerve branch.

The aim of the study will be to document the clinical results: neurological status of the patient, comparison of algesiological scales of pain, consumption of painkillers, in the time periods: before the procedure, after 6 weeks and then 6 and 12 months after the procedure, and subsequent statistical analysis of the data.

Description of the procedure

Endoscopic rhizotomy (denervation of facet joints) is a procedure where an endoscope is inserted into the area of the medial branch of the dorsal branch of the spinal nerve under X-ray visualization of the C-arm. Subsequently, the tissue around the medial branch is visualized with an endoscope. With the help of this visualization, we can remove the tissue with a sterile grasper and reveal the structure of the nerve. Finally, the medial branch is eliminated by a radiofrequency probe under constant endoscopic visualization. The procedure is completed by removing the endoscope and closing the incision with 1-2 sutures.

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