Endoscopic Facet Procedures

[caligas]

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Anybody doing or have thoughts on more "permanent" procedures for facet arthropathy that has responded well to RFA, but the patient is looking for a longer duration of relief?

For example:

Endoscopic Facet Debridement for the treatment of facet arthritic pain - a novel new technique

 

[lobelsteve]

Cost, time, duration, recovery.

RFA wins 3 out of 4. And if you compare repeat RFA over entire time of study it would still win.

Also, less risk, no scars.

 

[drpainfree]

facet joint debridement?

what's there to debride?

Do we have procedure to debride MCP joint for MCP joint arthritis?

Don't understand the rational of the technique.

 

[Aether2000]

Debridement could potentially reduce the inflammation within the joint and capsule. It could also disrupt the articular branches from the medial branch nerves. Long term, probably no more effective than RF, and certainly would not be a significant repeatable process. Surgical debridement is most likely covered under insurance only under some WC and litigation cases.

 

[drpainfree]

surgical debridement for small arthritic joint? the key word here is SMALL. Aren't you really just destroying a joint which can causes more reactive osteophyte?

 

[caligas]

Aside from "facet debridement" some places are touting endoscopic rhizotomy as having superior duration. Lobelsteve's post is probably spot on in response to that argument.


Five Year Long-Term Results of Endoscopic Dorsal Ramus Rhizotomy and Anatomic Variations of the Painful Lumbar Facet Joint

 

[Timeoutofmind]

Aside from "facet debridement" some places are touting endoscopic rhizotomy as having superior duration. Lobelsteve's post is probably spot on in response to that argument.


Five Year Long-Term Results of Endoscopic Dorsal Ramus Rhizotomy and Anatomic Variations of the Painful Lumbar Facet Joint

The variable anatomy depicted at the end is very interesting

 

[geauxg8rs]

The variable anatomy depicted at the end is very interesting

We should wait till jama or the New England journal weighs in. So we can get a real bias free opinion.
Lol