Percutaneous endoscopic denervation of intervertebral joints

A procedure in which the intervertebral joint is treated as a source of chronic lower back pain during endoscopic camera visualization. The cause of this pain is irritation of the medial branch nerves of the posterior branch of the nerve root, through which the intervertebral joint is innervated.

How does the procedure work?

Under X-ray control (C-arm), an endoscopic camera (endoscope) and a set of working tools is placed through the guide needle in the area of the medial branch nerves of the spinal nerve. Subsequently, we scan the tissue around the medial branch nerve with an endoscope. Under endoscopic control, we dissect the tissue with a sterile grasper (special forceps) and visualize the nerve structure. Finally, we coagulate the medial branch nerve (i.e. the medial branch nerve is interrupted) by a radiofrequency probe under the direct control of the endoscope. We end the procedure by removing the endoscope and closing the incision with 1 to 2 skin sutures.

  • Procedure without hospitalization
  • The operation takes place under local and light anesthesia (analgesia)
  • Duration of procedure from 60 to 90 minutes

What happens after the procedure

  • After the procedure, the patient stays in a special resting room for about 120 minutes to rest and then can return home accompanied by another person.
  • After the procedure, the patient will receive a medical report, where we recommend a 4 weeks sick-leave (issued by a general practitioner).
  • It is not possible to drive a car in person after the performance – it is necessary to ensure the patient has someone else to drive them, ideally for the patient to be in the passenger seat with the seat folded back.
  • For the first 1-2 days it is recommended to stay in bed, with limited sitting and standing, and during the first week a rest-regime.
  • From the 7th day after the operation, the patient enters the postoperative mode with movement recommendations, exercise and physiotherapy.
  • Return to normal activities and work is very individual. It depends on the patient’s health condition, the process of soft tissue healing, type of employment, etc. This is usually 4 to 6 weeks after the procedure.
  • We will contact you by phone in 24 hours and 14 days after the procedure.
  • Post-op check-up of your health condition at our clinics will take place 5-8 weeks after the operation.

How recovery takes place

The goal of treatment is to achieve relief from back pain by removing or reducing its intensity and thus improve the patient’s quality of life. During recovery, it is necessary to actively participate in the programme of postoperative and physical measures, which will help you recover faster and return to normal life. Your doctor will instruct you in detail about these measures immediately after the procedure. A “hotline” is available for patients immediately after endoscopic surgery, where you can contact a specialist nurse with any questions.

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