Cryoneurolysis for the Treatment of Cervical Facet Joint Syndrome: a Technical Note

Overview

Journal J Pain Res

Publisher Dove Medical Press

Date 2018 Jun 29

PMID 29950888

Citations 2

Authors

Tilman Wolter

Barbara Kleinmann

Stefan Knoeller

Affiliations

Soon will be listed here.

Abstract

Objective: Neck pain has an annual prevalence of 30%. A frequent cause of neck pain is cervical facet joint pain. In cases of refractory cervical facet joint pain, radiofrequency can be employed, but the grade of evidence attested in systematic reviews is fair. Cryoneurolysis has been reported to induce favorable outcomes in lumbar facet joint pain. We sought to examine the feasibility of cervical facet joint cryoneurolysis.

Setting: Tertiary academic pain center.

Patients And Methods: We report here the operative technique of cervical facet joint cryoneurolysis for patients with cervical facet joint pain. The procedure is performed under CT-guidance. The lesion points are defined with the help of sensory stimulation.

Results: Six cervical facet joint denervations were carried out in five patients. All patients had an uneventful course with adequate pain relief. Apart from soreness of the paravertebral muscles no severe side effects were encountered.

Conclusion: This is the first report of cryoneurolysis for the treatment of cervical facet joint pain. The technique is feasible and warrants further studies.

Citing Articles

Minimally invasive interventional therapy for pain.

Hua Y, Wu D, Gao T, Liu L, He Y, Ding Y J Interv Med. 2023; 6(2):64-68.

PMID: 37409059 PMC: 10318327. DOI: 10.1016/j.jimed.2023.03.003.

Interventional Cryoneurolysis: What Is the Same, What Is Different, What Is New?.

Bittman R, Behbahani K, Gonzalez F, Prologo J Semin Intervent Radiol. 2019; 36(5):374-380.

PMID: 31798210 PMC: 6887526. DOI: 10.1055/s-0039-1696705.

References

Govind J, King W, Bailey B, Bogduk N . Radiofrequency neurotomy for the treatment of third occipital headache. J Neurol Neurosurg Psychiatry. 2002; 74(1):88-93. PMC: 1738184. DOI: 10.1136/jnnp.74.1.88. View

Nath S, Nath C, Pettersson K . Percutaneous lumbar zygapophysial (Facet) joint neurotomy using radiofrequency current, in the management of chronic low back pain: a randomized double-blind trial. Spine (Phila Pa 1976). 2008; 33(12):1291-7. DOI: 10.1097/BRS.0b013e31817329f0. View

Trescot A . Cryoanalgesia in interventional pain management. Pain Physician. 2006; 6(3):345-60. View

van Kleef M, Barendse G, Kessels A, Voets H, Weber W, de Lange S . Randomized trial of radiofrequency lumbar facet denervation for chronic low back pain. Spine (Phila Pa 1976). 1999; 24(18):1937-42. DOI: 10.1097/00007632-199909150-00013. View

Dobrogowski J, Wrzosek A, Wordliczek J . Radiofrequency denervation with or without addition of pentoxifylline or methylprednisolone for chronic lumbar zygapophysial joint pain. Pharmacol Rep. 2005; 57(4):475-80. View

Datta S, Lee M, Falco F, Bryce D, Hayek S . Systematic assessment of diagnostic accuracy and therapeutic utility of lumbar facet joint interventions. Pain Physician. 2009; 12(2):437-60. View

Aprill C, Dwyer A, Bogduk N . Cervical zygapophyseal joint pain patterns. II: A clinical evaluation. Spine (Phila Pa 1976). 1990; 15(6):458-61. DOI: 10.1097/00007632-199006000-00005. View

Moore W, Kolnick D, Tan J, Yu H . CT guided percutaneous cryoneurolysis for post thoracotomy pain syndrome: early experience and effectiveness. Acad Radiol. 2010; 17(5):603-6. DOI: 10.1016/j.acra.2010.01.009. View

Gazelka H, Knievel S, Mauck W, Moeschler S, Pingree M, Rho R . Incidence of neuropathic pain after radiofrequency denervation of the third occipital nerve. J Pain Res. 2014; 7:195-8. PMC: 3986282. DOI: 10.2147/JPR.S60925. View

10.

Cohen S, Williams K, Kurihara C, Nguyen C, Shields C, Kim P . Multicenter, randomized, comparative cost-effectiveness study comparing 0, 1, and 2 diagnostic medial branch (facet joint nerve) block treatment paradigms before lumbar facet radiofrequency denervation. Anesthesiology. 2010; 113(2):395-405. DOI: 10.1097/ALN.0b013e3181e33ae5. View

11.

Sapir D, Gorup J . Radiofrequency medial branch neurotomy in litigant and nonlitigant patients with cervical whiplash: a prospective study. Spine (Phila Pa 1976). 2001; 26(12):E268-73. DOI: 10.1097/00007632-200106150-00016. View

12.

DREYFUSS P, Halbrook B, Pauza K, Joshi A, McLarty J, Bogduk N . Efficacy and validity of radiofrequency neurotomy for chronic lumbar zygapophysial joint pain. Spine (Phila Pa 1976). 2000; 25(10):1270-7. DOI: 10.1097/00007632-200005150-00012. View

13.

Green C, de Rosayro A, Tait A . The role of cryoanalgesia for chronic thoracic pain: results of a long-term follow up. J Natl Med Assoc. 2002; 94(8):716-20. PMC: 2594272. View

14.

Birkenmaier C, Veihelmann A, Trouillier H, Hausdorf J, von Schulze Pellengahr C . Medial branch blocks versus pericapsular blocks in selecting patients for percutaneous cryodenervation of lumbar facet joints. Reg Anesth Pain Med. 2007; 32(1):27-33. DOI: 10.1016/j.rapm.2006.08.014. View

15.

Engel A, Rappard G, King W, Kennedy D . The Effectiveness and Risks of Fluoroscopically-Guided Cervical Medial Branch Thermal Radiofrequency Neurotomy: A Systematic Review with Comprehensive Analysis of the Published Data. Pain Med. 2015; 17(4):658-69. DOI: 10.1111/pme.12928. View

16.

Dwyer A, Aprill C, Bogduk N . Cervical zygapophyseal joint pain patterns. I: A study in normal volunteers. Spine (Phila Pa 1976). 1990; 15(6):453-7. DOI: 10.1097/00007632-199006000-00004. View

17.

Lakemeier S, Lind M, Schultz W, Fuchs-Winkelmann S, Timmesfeld N, Foelsch C . A comparison of intraarticular lumbar facet joint steroid injections and lumbar facet joint radiofrequency denervation in the treatment of low back pain: a randomized, controlled, double-blind trial. Anesth Analg. 2013; 117(1):228-35. DOI: 10.1213/ANE.0b013e3182910c4d. View

18.

Cohen S . Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc. 2015; 90(2):284-99. DOI: 10.1016/j.mayocp.2014.09.008. View

19.

Staender M, Maerz U, Tonn J, Steude U . Computerized tomography-guided kryorhizotomy in 76 patients with lumbar facet joint syndrome. J Neurosurg Spine. 2005; 3(6):444-9. DOI: 10.3171/spi.2005.3.6.0444. View

20.

Speldewinde G . Outcomes of percutaneous zygapophysial and sacroiliac joint neurotomy in a community setting. Pain Med. 2010; 12(2):209-18. DOI: 10.1111/j.1526-4637.2010.01022.x. View