Acta Neurochirurgica

, Volume 158, Issue 5, pp 995–998 | Cite as

Percutaneous radiofrequency thermocoagulation of dorsal ramus branches as a treatment of “lumbar facet syndrome” - How I do it

  • Mattia PacettiEmail author
  • Pietro Fiaschi
  • Sergio Gennaro
How I Do it - Spine



Low back pain is an extremely common and often chronic condition. In some cases, this is due to an irritative arthropathy of zygapophyseal joint involving the medial branch of the dorsal ramus of the spinal nerve. Percutaneous radiofrequency thermocoagulation appears to be the most effective treatment to date, among a range of different treatments. In this paper, the technique is described as performed at out institution.


In supine position and under fluoroscopic control, a radiofrequency electrode is inserted into different articular zygapophyseal complexes to thermocoagulate ramifications of the medial branch of the dorsal primary ramus of the spinal nerve.


Fluoroscopic-guided percutaneous radiofrequency thermocoagulation of dorsal rami branches is a safe and reliable technique for the treatment of lumbar facet syndrome. Careful selection of patients based on clinical presentation and positive anesthetic block test are key points for an optimum outcome.


Chronic low back pain Thermocoagulation Pain management Spine 


Compliance with ethical standards


No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Supplementary material


The attached video shows one step of the procedure. The cannula is positioned as described in the text, local anesthesia is injected, the probe is inserted, and the position is corrected under fluoroscopic control. Then thermocoagulation is performed. The probe is moved as described in the text and thermocoagulation is repeated. (MP4 167455 kb)


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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Mattia Pacetti
    • 1
    Email author
  • Pietro Fiaschi
    • 1
  • Sergio Gennaro
    • 2
  1. 1.School of Neurosurgery, IRCCS Ospedale San Martino- ISTUniversità di Torino, Università degli studi di GenovaGenoaItaly
  2. 2.U.O. Neurochirurgia, IRCCS Ospedale San Martino- ISTGenoaItaly

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