Minimally Invasive Procedure Has Profound Effect on Back Pain

Stephanie Lachapelle for Back1

A new study presented at the 26th Annual Meeting of the American Academy of Pain Medicine shows that a new, minimally invasive facet arthrodesis procedure significantly reduced back pain due to facet-mediated lower back pain.

Many who suffer from lower back pain have recurrent facet-mediated lower back pain, in which the movement of the joints of the lower vertebrae stimulates local nerve endings in the joint, causing pain. Facet arthrodesis is a procedure in which the affected joint is immobilized so movement no longer causes pain. Much of the pain associated with this procedure is actually due to the disruption of muscles and ligaments surrounding the joint, causing post-surgery pain. Many patients are treated with thermal radiofrequency, a procedure in which heat is used to cut off nerve sensation to the site of pain, but symptoms recur after about 10 months.

The new facet arthodesis procedure involves only a small incision. Pins are placed in the joints of the affected area, allowing a small drill to enter the joint. A special bone graft, called a Morse-tapered allograft, is placed in the joint. The graft grows directly into the joint, causing immobilization and relieving pain.
Dr. Daniel Bennett from Integrative Treatment Centers in Denver, Colorado, performed this procedure on 102 patients suffering from recurrent facet-mediated back pain. After one year, pain was reduced from 79 to 23 on a Visual Analog Scale, and function improved from 33.46 to 8.32 on an Oswetry Disability Index, two tests commonly used to assess pain. 92% of patients also reported discontinuing narcotic pain medication.

"This is an impressive technique which had a profound positive effect on the patients in this pilot study," said Dr. Bennett. "It has the potential to be a long-term solution to intractable back pain due to joint disease."

A multi-center protocol is now in development to compare these results to patients treated with conventional pain methods.

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Last updated: 08-Feb-10