Minimal invasive methods of diagnostic and treatment of facet-syndrome pain (literature review)

Olexandr Perfiliev, Volodymyr Radchenko, Volodymyr Kutsenko, Andrey Popov, Artem Skidanov, Valentyn Piontkovsky

Abstract


Purpose: on the basis of the analysis of the scientific literature, to study the most significant problems of interventional methods of diagnosis and treatment of painful facet syndrome in lumbar spondylarthrosis, and to determine the ways of their solution.

Methods: publications for the last 20 years from electronic da­tabases PubMed, MEDLINE, articles, monographs, authors ab­stracts, dissertations and other sources of scientific and medical information have been studied. 178 publications on the lumbar pain facet syndrome, 199 — lumbar medial branches of the pos­terior branches of the spinal cord nerves, 1 062 — blockade and denervation of the lumbar arched joints, 7 — their endo­scopic denervation. 74 publications with II and III levels of evi­dence were selected.

Results: an increase in the prevalence of the use of minimally invasive diagnostic blockades and dener­vation of the facets in the lumbar spine resulted in an increase in the number of not only positive, but also unsatisfactory re­sults. It has been established that the innervation of facets has individual anatomical and topographical features of the loca­tion of the nerves, which can influence the results of minimally invasive methods of treatment of the facet syndrome. Selective blockages of the medial branches of the posterior branches of the spinal nerves and intra-articular blockade of the facets, with observance of qualitative control, are effective for short-term treatment of the chronic painful facet syndrome, and de­nervation of the facets in the form of a neurotomy of the said branches under endoscopic control is the most successful method for achieving long-term The main ways of improving mini­mally invasive methods for diagnosis and treatment of painful facet syndrome of lumbar spondylarthrosis have been found.

Keywords


lumbar spine; painful facet syndrome; medial branches of the posterior branches of the spinal nerves; therapeutic and diagnostic blockages of facet joints; denervation of facet joints; endoscopic denervation

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DOI: https://doi.org/10.15674/0030-598720171128-137

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