Full-Endoscopic Lumbar Rhizotomy for the Treatment of Facetogenic Low Back Pain: A Systematic Review of the Current Literature
10.21182/jmisst.2024.01844
- Author:
Chao-Jui CHANG
;
Yuan-Fu LIU
;
Yu-Meng HSIAO
;
Wei-Lun CHANG
;
Yi-Hung HUANG
;
Keng-Chang LIU
;
Che-Chia HSU
;
Ming-Long YEH
;
Cheng-Li LIN
- Publication Type:Review Article
- From:
Journal of Minimally Invasive Spine Surgery and Technique
2025;10(Suppl 1):S42-S51
- CountryRepublic of Korea
- Language:English
-
Abstract:
Chronic low back pain (CLBP) is a pervasive and debilitating condition, affecting millions of individuals globally and imposing a significant burden on healthcare systems. Traditional treatment modalities often have limited efficacy, leading to the exploration of novel therapeutic interventions. Endoscopic rhizotomy (ER) has emerged as a promising technique, particularly for managing facetogenic pain. This systematic review presents a comprehensive overview of the historical evolution, current practices, and clinical outcomes associated with ER in the treatment of CLBP. This systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive literature search was conducted in Embase, PubMed, and the Cochrane Central Register of Controlled Trials, covering publications up to February 1, 2024, utilizing specific keywords related to low back pain (LBP) and full-endoscopic lumbar rhizotomy. Data extraction focused on patient demographics, clinical outcomes, and any reported complications associated with this procedure. Ten selected studies, comprising a total of 529 patients, were included. Approximately 96.7% to 97.8% of patients who underwent ER reported excellent or good results based on the MacNab score. Patients treated with ER demonstrated significantly better visual analogue scale scores (mean difference: -2.39; 95% confidence interval [C]I, -3.15 to -1.63; p<0.00001) and showed greater improvement on the Oswestry Disability Index (mean difference: -19.97; 95% CI, -37.48 to -2.46; p=0.03) than those treated with traditional percutaneous radiofrequency ablation (TPRA). No major postoperative complications were reported. Full-endoscopic lumbar rhizotomy represents a significant advancement in the treatment of CLBP, especially in cases involving facetogenic pain. The procedure offers superior outcomes compared to TPRA, with higher patient satisfaction rates and improved clinical outcomes. The absence of major complications highlights its potential as a therapeutic option for facetogenic LBP. However, the findings are limited by the small number of studies, varying follow-up durations, and potential publication bias.
