Nova Clinic, Biberach, Baden-Württemberg, Germany.
Pain Physician. 2012 Jan-Feb;15(1):E71-8.
Degenerative spondylolisthesis is one of the major causes for low back pain. Morphological abnormalities of the zygapophysial joints are a predisposing factor in the development of degenerative spondylolisthesis. Therefore, radiofrequency neurotomy seems to be a rational therapy.
To determine if radiofrequency neurotomy is effective for patients with low back pain and degenerative spondylolisthesis.
Retrospective practice audit.
Single spine center
Charts of all patients with degenerative spondylolisthesis who underwent treatment with radiofrequency neurotomy during a time period of 3 years were reviewed. Only patients with magnetic resonance imaging confirming the diagnosis were included. Patients with a lumbar spine operation in their history, patients with neurological deficits, and patients with a follow-up less than 3 months were excluded. Patients were treated with lumbar radiofrequency neurotomy. Positive treatment response was defined as at least a 50% reduction in pain. A radiofrequency neurotomy was only performed after positive diagnostic medial branch blocks.
During a time period of 3 years, 1,490 patients were treated with lumbar radiofrequency neurotomy. Forty of these patients with degenerative spondylolisthesis were included. A significant pain reduction was achieved in 65 % of the patients.
This audit is retrospective and observational, and therefore does not represent a high level of evidence. However, to our knowledge, since this information has not been previously reported and no specific nonoperative treatment for lumbar pain in patients with degenerative spondylolisthesis exists, it appears to be the best available research upon which to recommend treatment and to plan higher quality studies.
Zygapophysial joints are a possible source of pain in patients with spondylolisthesis. Radiofrequency neurotomy is a rational, specific nonoperative therapy in addition to other nonoperative therapy methods with a success rate of 65%. This is the first study to determine the effect of radiofrequency neurotomy in patients with minor degenerative spondylolisthesis.
退行性脊椎滑脱是腰痛的主要原因之一。关节突关节的形态异常是退行性脊椎滑脱发展的一个诱发因素。因此，射频神经切断术似乎是一种合理的治疗方法。
确定射频神经切断术是否对腰痛和退行性脊椎滑脱患者有效。
回顾性实践审计。
单脊柱中心
回顾了在 3 年时间内接受射频神经切断术治疗的退行性脊椎滑脱患者的所有病历。仅包括经磁共振成像（MRI）确诊的患者。排除有腰椎手术史、有神经功能缺损和随访时间少于 3 个月的患者。患者接受了腰椎射频神经切断术。阳性治疗反应定义为疼痛至少减轻 50%。仅在经内侧支阻滞诊断阳性后才进行射频神经切断术。
在 3 年时间内，有 1490 例患者接受了腰椎射频神经切断术治疗。其中 40 例退行性脊椎滑脱患者纳入研究。65%的患者疼痛明显减轻。
本次审计为回顾性和观察性研究，因此不代表高水平的证据。然而，据我们所知，由于这些信息以前没有报道过，而且对于退行性脊椎滑脱患者的腰痛没有特定的非手术治疗方法，因此这似乎是目前可推荐治疗方案和计划开展更高质量研究的最佳研究。
关节突关节是脊椎滑脱患者疼痛的一个可能来源。射频神经切断术是一种合理的、特定的非手术治疗方法，可与其他非手术治疗方法联合使用，成功率为 65%。这是第一项确定射频神经切断术对轻度退行性脊椎滑脱患者疗效的研究。
