Percutaneus Electrical Denervation of Posterior Medial Branch for Lumbar Posterior Joint Pain.

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The purpose of this paper is to discribe experimental and clinical study for percutaneus electrical denervation of lumbar posterior medial branchi. Experimental study showed that optimum Joules's heat in this procedure is 10W×20seconds×2times. Clinically, 20 patients with lumbar facet pain were done this procedure, There were 12males and 8females. The mean age of this group of patients was 55 years with a range from 25 to 78 years. The duration of follow-up varied from 3 months to 3 years and 9 months, the average being 1 year and 5 months.The main advantages of this procedure are as follows:1) As target point of denervation is between mammillary process and accessory process, electrical denervation is safe, so that the target point is far from spinal nerve roots.2) Denervation at this point preserve function of all back muscle except multifidus muscle. Because of this, this procedure can minimize weakness of back muscle after the procedure.3) Effect of denervation can be judged by electromyography of multifidus muscle. Sixteen cases have good clinical course. Four cases have poor results. Diagnoses of poor cases are 2 psychogenic low back pain, multiple lumbar facet pain and lumbar disc herniation.Indication of this procedure should be strict all the more because it is very easy.
西日本整形・災害外科学会の論文