Associate Professor University of Utah University of Utah Salt Lake City, UT, US
Introduction: Lumbar facet syndrome is a common cause of chronic low back pain (LBP), affecting not only the elderly, with a prevalence ranging from 15% to 45% of LBP cases. Treatment options include pain medication, physiotherapy, intra-articular injections, medial branch blocks, and minimally invasive surgical procedures when radiofrequency neurotomy (RFN) is ineffective.
RFN has reported success rates of 53-60%, providing pain relief for 10-15 months. Repeated procedures show similar efficacy to initial treatments, but recurrence is possible. Endoscopic medial branch neurectomy is a promising, minimally invasive procedure that could improve treatment outcomes. Unlike ablation, which allows for nerve regeneration, this technique prevents regeneration, potentially enhancing long-term results. More data from additional patients is needed to better understand the risks and benefits.
This surgical video aims to explain the procedure and encourage other surgeons to adopt it. We demonstrate the case of a 39-year-old woman with a history of L2 burst fracture treated with T12-L4 posterior fusion in 2015, presenting with facet pain syndrome, L3 to L5. The video covers the technical aspects with a 2D surgical demonstration.
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