The application of intraoperative neurophysiological monitoring in selective dorsal neurotomy for primary premature ejaculation: a prospective single-center study / 亚洲男科学杂志(英文版)

Selective dorsal neurotomy (SDN) is a surgical treatment for primary premature ejaculation (PE), but there is still no standard surgical procedure for selecting the branches of the dorsal penile nerves to be removed. We performed this study to explore the value of intraoperative neurophysiological monitoring (IONM) of the penile sensory-evoked potential (PSEP) for standard surgical procedures in SDN. One hundred and twenty primary PE patients undergoing SDN were selected as the PE group and 120 non-PE patients were selected as the normal group. The PSEP was monitored and compared between the two groups under both natural and general anesthesia (GA) states. In addition, patients in the PE group were randomly divided into the IONM group and the non-IONM group. During SDN surgery, PSEP parameters of the IONM group were recorded and analyzed. The differences in PE-related outcome measurements between the perioperative period and 3 months' postoperation were compared for the PE patients, and the differences in effectiveness and complications between the IONM group and the non-IONM group were compared. The results showed that the average latency of the PSEP in the PE group was shorter than that in the normal group under both natural and GA states (P < 0.001). Three months after surgery, the significant effective rates in the IONM and non-IONM groups were 63.6% and 34.0%, respectively (P < 0.01), and the difference in complications between the two groups was significant (P < 0.05). IONM might be useful in improving the short-term therapeutic effectiveness and reducing the complications of SDN.

Vitrectomy with arteriotomy and neurotomy in retinal artery occlusion – A case series

Purpose: This study aimed to investigate the visual outcomes and anatomical changes after vitrectomy for retinal artery occlusion. Methods: Twelve patients with retinal artery occlusion (11 central retinal artery occlusion and 1 branch retinal artery occlusion) were part of this study. Our patients were treated with vitrectomy with arteriotomy or with neurotomy and arteriotomy. Complete ophthalmic examination was performed preoperatively, at 2 weeks, and 1, 3, 6, 9, and 12 months after surgery. Results: The mean preoperative best?corrected visual acuity (BCVA) was 1.94 logMAR, and the final BCVA after 12?months follow?up was 2.04 logMAR. After vitrectomy with arteriotomy, the BCVA in patients treated with neurotomy and arteriotomy was 1.65 and 2.45, respectively (P = 0.038). Conclusion: No benefits have been achieved from using vitrectomy in retinal artery occlusion cases

Clinical study of 80 patients with spasmodic cerebral palsy undergoing microsurgery / 西安交通大学学报(医学版)

【Objective】 To discuss and summarize the choice of the operation plan and evaluation of curative effect of spasmodic cerebral palsy. 【Methods】 Clinical data of 80 patients with spastic cerebral palsy treated by neurosurgery in The First Affiliated Hospital of Xi’an Jiaotong University were collected retrospectively and analyzed statistically. Eighty patients were followed up for 12 to 52 months, with an average follow-up of 21.3 months. The muscle tension grading, spasm index, range of motion, Holden walking ability and postoperative complications were compared one year after surgery. 【Results】 Totally 64 cases received selective posterior rhizotomy (SPR) combined muscle strength muscle tension adjustment method (MMA) and 16 cases selective peripheral neurotomy combined muscle strength muscle tension adjustment method. The grade and spasm index of muscle tension decreased significantly one year after operation (P<0.001). The range of joint motion and Holden walking ability were significantly improved (P<0.001). Transient urination disorder occurred in two cases (2.5%), and limb sensation disorder in two cases (2.5%), all of which were improved within three months. Weakness of dorsiflexion of foot in one case (1.25%). 【Conclusion】 Selective partial neurotomy and muscle tension adjustment is a safe and effective surgical method to treat spasmodic cerebral palsy. Real-time evaluation of muscle tension and ankle clonus changes during the operation is an important factor to ensure the postoperative efficacy.

The etiology, diagnosis and treatment of sialorrhea / 口腔疾病防治

@#Sialorrhea is a group of symptoms characterized by excessive accumulation of saliva in the mouth and unconscious overflow from the mouth. It can be divided into physiological sialorrhea and pathological sialorrhea. The etiology of sialorrhea is complex. Local oral factors, systemic diseases, drug induction or psycho-physiological factors can lead to excessive saliva secretion or excessive saliva storage in the mouth, which can lead to sialorrhea. Physiological sialorrhea generally does not require treatment, while different treatment strategies are needed in cases of pathological sialorrhea. There are many treatments for sialorrhea, including oral and maxillofacial system training, drugs, botulinum toxin injection, surgical treatment, and less commonly, traditional Chinese medicines, radiotherapy and neuromuscular electrical stimulation therapy. For different patients, different treatment methods should be adopted, and the treatment should be gradual. To correct the abnormalities in the oral and maxillofacial regions, the primary disease should be treated, contact with/the use of substances inducing salivation should be stopped, or psychological treatment should be administered, combined with oral and maxillofacial system training; if the effect is not good, invasive treatment, such as surgery, should be considered. At present, there are no unified, clear diagnostic criteria or simple and effective treatments in the clinic. In this paper, the etiology, diagnosis and treatment of sialorrhea, combined with our group′s many years of experience in the diagnosis and treatment of sialorrhea, are reviewed to provide a useful reference for the clinical diagnosis and treatment of sialorrhea.

Progresses in pharmaceutical and surgical management of premature ejaculation / 中华医学杂志(英文版)

Objective@#Premature ejaculation (PE) is regarded as one of the most common male sexual dysfunctions. This review introduced several pharmaceutical and surgical methods for the management of PE. The definition, etiology, behavioral, and psychological therapy of PE were also discussed.@*Data sources@#"Premature," "ejaculation," or "sexual dysfuction" were used as the medical subject headings (MeSH) to obtain relevant articles before June 2019 on Pubmed, Google Scholar and CNKI. Most articles used were written in English and several Chinese articles were also cited.@*Study selection@#Full-text articles of retrospective/prospective/randomized controlled trials were analyzed. Animal experiments and letters were excluded.@*Results@#There are four PE sub-types: lifelong PE, acquired PE, natural variable PE, and subjective PE. Behavioral therapy, psychotherapy, medication, topical anesthetics, and surgery are currently used for the treatment of PE. However, all the above treatments have limitations. Therefore, novel ways should be investigated to more efficiently control PE.@*Conclusions@#The pharmaceutical therapy that is currently being used in clinical practice for the management of PE is still the main choice globally due to its good efficacy. Surgery may be a choice for patients who are resistant to medication. However, it should be performed cautiously.

Comparison of Treatment Methods in Lumbar Spinal Stenosis for Geriatric Patient: Nerve Block Versus Radiofrequency Neurotomy Versus Spinal Surgery

OBJECTIVE: The incidence of spinal treatment, including nerve block, radiofrequency neurotomy, instrumented fusions, is increasing, and progressively involves patients of age 65 and older. Treatment of the geriatric patients is often a difficult challenge for the spine surgeon. General health, sociofamilial and mental condition of the patients as well as the treatment techniques and postoperative management are to be accurately evaluated and planned. We tried to compare three treatment methods of spinal stenosis for geriatric patient in single institution. METHODS: The cases of treatment methods in spinal stenosis over than 65 years old were analyzed. The numbers of patients were 371 underwent nerve block, radiofrequency neurotomy, instrumented fusions from January 2009 to December 2012 (nerve block: 253, radiofrequency neurotomy: 56, instrumented fusions: 62). The authors reviewed medical records, operative findings and postoperative clinical results, retrospectively. Simple X-ray were evaluated and clinical outcome was measured by Odom's criteria at 1 month after procedures. RESULTS: We were observed excellent and good results in 162 (64%) patients with nerve block, 40 (71%) patient with radIofrequency neurotomy, 46 (74%) patient with spinal surgery. Poor results were 20 (8%) patients in nerve block, 2 (3%) patients in radiofrequency neurotomy, 3 (5%) patient in spinal surgery. CONCLUSION: We reviewed literatures and analyzed three treatment methods of spinal stenosis for geriatric patients. Although the long term outcome of surgical treatment was most favorable, radiofrequency neurotomy and nerve block can be considered for the secondary management of elderly lumbar spinals stenosis patients.

Impact of the peripheral neurotomy method combined with rehabilitation exercise on gross motor function and balance function of children with cerebral palsy / 中华实用儿科临床杂志

Objective To study the impact of the peripheral neurotomy method combined with rehabilitation exercise on gross motor function and balance function of children with cerebral palsy.Methods Matched pair design was used in the study.Thirty children with spastic cerebral palsy hospitalized from May 2011 to Nov.2013 suffering from peripheral neurotomy were assigned as study group,who were conscious and treated by peripheral neurotomy com bined with rehabilitation exercise.In the meanwhile,30 children inpatients at the same time were employed as the control group,who were similar in age and symptoms,with the same gender and the same Gross motor function classification (GMFCS) grade,and the controls were treated only with ordinary rehabilitation exercise.Modified Ashworth score,Gross Motor Function Measure (GMFM) D and E regions scores,physicians rating scale score in the 2 groups were recorded after treatment for 2,4,6,8,10 weeks.Repeated measure analysis of variance method was introduced to analyze the differences between the 2 groups in improved Ashworth muscle tension,gait improvement,gross motor function and balance function.Results The study group was superior over the control group in muscle tension reduction (F =8.177,P =0.006) and gait improvement(F =24.284,P =0.000).The 2 groups were not different statistically in D region evaluation of GMEM (F =0.072,P =0.790) and E region evaluation of GMFM (F =0.000,P =0.985) ; For Berg balance scale,the 2 groups had also no difference(F =0.150,P =0.700).Conclusions Both peripheral neurotomy method combined with rehabilitation exercise and the ordinary rehabilitation exercise method both could improve the gross function and the balance function.Furthermore,the former was superior over the latter in muscle tension reduction and gait improvement.

Effectiveness of Repeated Radiofrequency Neurotomy for Facet joint Syndrome after Microscopic Discectomy

OBJECTIVE: Postoperative facet joint syndrome requiring radiofrequency neurotomy (RFN) is a relatively common problem following microscopic discectomy. However, the efficacy of repeated RFN after microscopic discectomy has not been clearly documented. The purpose of this study was to determine the success rate and symptom-free duration of repeated RFN for facet joint syndrome after microscopic discectomy. METHODS: Medical records from 56 patients, who had undergone successful initial RFN following microscopic discectomy, experienced recurrence of pain, and subsequently had repeated RFN, were reviewed and evaluated. Responses of repeated RFN were compared with initial radiofrequency neurotomy for success rates and duration of relief. The criterion for RFN to be successful was defined as greater than 50% relief from pain and sufficient satisfaction of patients with prior RFN to have repeated RFN. RESULTS: Fifty-six patients (41 women and 15 men; mean age=48 years) had repeated RFNs, which were successful in all except three patients. RFN denervated three bilateral segments (L3-L4, L4-L5, and L5-S1) in all patients. Mean duration of relief after initial RFN was 9.2 months (range 3-14). The mean duration of relief after secondary RFN in 53 patients was 9.0 months (range 4-14). The success rates and duration of relief remained consistent after subsequent RFNs. CONCLUSION: Repeated RFN for lumbar facet joint pain after microscopic discectomy is an effective palliative treatment. It provided a mean duration of relief of 9.0 months and >94% success rate.

The Effect of Radiofrequency Neurotomy of Lower Cervical Medial Branches on Cervicogenic Headache

OBJECTIVE: Cervicogenic headache (CGH) is known to be mainly related with upper cervical problems. In this study, the effect of radiofrequency neurotomy (RFN) for lower cervical (C4-7) medial branches on CGH was evaluated. METHODS: Eleven patients with neck pain and headache, who were treated with lower cervical RFN due to supposed lower cervical zygapophysial joint pain without symptomatic intervertebral disc problem or stenosis, were enrolled in this study. CGH was diagnosed according to the diagnostic criteria of the cervicogenic headache international study group. Visual analogue scale (VAS) score and degree of VAS improvement (VASi) (%) were checked for evaluation of the effect of lower cervical RFN on CGH. RESULTS: The VAS score at 6 months after RFN was 2.7+/-1.3, which were significantly decreased comparing to the VAS score before RFN, 8.1+/-1.1 (p<0.001). The VASi at 6 months after RFN was 63.8+/-17.1%. There was no serious complication. CONCLUSION: Our data suggest that lower cervical disorders can play a role in the genesis of headache in addition to the upper cervical disorders or independently.

Selective Musculocutaneous Neurotomy for Spastic Elbow

OBJECTIVE: The purpose of this study was to investigate the effectiveness and outcome of selective musculocutaneous neurotomy (SMcN) for spastic elbow. METHODS: We retrospectively reviewed the medical records of 14 patients with spasticity of their elbows. The patients were selected using clinical and analytical scales, as well as nerve block tests, for assessment. Their mean age was 37.29 years (range, 19-63 years). SMcN was performed for these patients, and the mean follow-up period was 30.71 months (range, 19-54 months). RESULTS: The modified Ashworth scale (MAS) scores recorded before and after the SMcN showed that the patients' mean preoperative MAS score of 3.28 +/- 0.12 was improved to 1.71 +/- 0.12, 1.78 +/- 0.18, 1.92 +/- 0.16 and 1.78 +/- 0.18 at postoperative 3, 6, 12 months and last follow-up, respectively. On the basis of a visual analogue score ranging from 0-100, the patients' mean degree of satisfaction score was 65.00 +/- 16.52 (range, 30-90). CONCLUSION: We believe that SMcN can be a good and effective treatment modality with low morbidity in appropriately selected patients who have localized spastic elbow with good antagonist muscles and without joint contracture.

The Efficacy of Repeated Radiofrequency Medial Branch Neurotomy for Lumbar Facet Syndrome

OBJECTIVE: Radiofrequency (RF) medial branch neurotomy is an effective management of lumbar facet syndrome. However, pain may recur after period of time. When pain recurs, it can be repeated, but the successful outcome and duration of relief from repeated procedures are not clearly known. The objective of this study was to determine the success rate and duration of pain relief from repeated radiofrequency medial branch neurotomy for lumbar facet syndrome. METHODS: A retrospective review of medical records was done on 60 consecutive patients, from March of 2006 to February of 2009, who had an initial successful RF neurotomy but subsequently underwent repeated procedures due to recurrence of pain. All procedures were done in carefully selected patients after at least two responsive medial branch nerve blocks. C-arm fluoroscopic guide, impedance, sensory and motor threshold monitoring tools were used for the precise placement of electrodes. Responses of repeated procedures were compared with initial radiofrequency neurotomy for success rates and duration of pain relief. RESULTS: There were 48 females and 12 males. Mean age was 52.4 years (range, 26-83). RF medial branch neurotomy was done on one side in 38 and both sides in 22 patients, each covering at least three segments. Average visual analog scale at last procedure was 6.8. Twelve patients had previous lumbar operations, including 4 patients with instrumentations. Fifty-five patients had two procedures and five patients had three procedures. Mean duration of successful pain relief (> 50% of previous pain for at least 3 months period) after initial radiofrequency neurotomy was 10.9 months (range, 3-28) in 51 (85%) patients. From repeated procedures, successful pain relief was seen in 50 (91%) patients with average duration of 10.2 months (range, 3-24). Five patients had third procedure, which was successful in 4 (80%) patients with mean duration of 9.8 months (range, 5-16). This was not statistically different from initial results. There were no permanent neurological complications from the procedures. CONCLUSION: Results of this study indicate that the frequency of success and durations of relief from repeated RF medial branch neurotomy for lumbar facet syndrome are similar to initial results that provided relatively prolonged period of pain relief without major side effects. Each procedure seems to provide successful pain relief for about 10 months in more than 85% of carefully selected patients when properly done.

Selective partial neurotomy of muscular branch of triceps in the treatment Of Spastic talipes equines / 国际外科学杂志

Objective To summarize and explore the clinical value of selective partial neurotomy of muscular branch of triceps in the treatment of spastic talipes equines.Methods Forty-two cases were included in our study from Aug.2000 to Des.2007,all these cases accepted the operation of selective partial neurotomy muscular branch of triceps.In this study,29 cases were male,13 cases were female.Muscle force of legs,muscular tension,pathologic reflex,gesture and function of legs after operation were compared with that of before operation.Results The mean fallow-up was 18 months.During the fallow-up of this study,muscular tension degraded,the function of ankle joints and the gesture of extremitas inferior were improved obviously.The effective power was about 90% after 12 months follow-up.Conclusions Selective partial neurotomy of muscular branch of triceps is a effective method for the treatment of spastic talipes equines.The operation procedure is simple and effective,and could be generalized in the primary level hospital.

Traumatic lesions of internal saphenous nerve and branches / Lesões traumáticas do nervo safeno interno e seus ramos

OBJECTIVE: To show a rare lesion that sometimes simulates vascular disorder of the lower extremities. METHOD: Three patients were operated and the follow-up period was eight months, the surgical technique was neurotomy of the infrapatellar and descendent branches. RESULTS: In two cases there were almost total pain resolution, and in other case improvement only. CONCLUSION: Surgical treatment yields good results in this type of internal saphenous nerve lesion, and could be useful as an alternative to conservative treatment.

OBJETIVO: Apresentar lesões raras do nervo safeno interno interno, que muitas vezes, simulam doenças vasculares dos membros inferiores. MÉTODO: Três pacientes foram operados e acompanhados por um período de oito meses. A técnica cirúrgica consistiu na neurotomia dos ramos infrapatelar e descendente do nervo safeno interno. RESULTADOS: Nos dois primeiros casos houve quase desaparecimento total da dor em pouco tempo e no terceiro apenas melhora. CONCLUSÃO: O tratamento cirúrgico dá bons resultados neste tipo de lesão do nervo safeno interno e poderia ser útil como alternativa ao tratamento conservador.

Where will the surgical treatment of central retinal vein occlusion go? / 眼科

There are many research reports about surgical treatments for central retinal vein occlusion (CRVO) up to date, such as radial optic neurotomy, vitrectomy combined with internal limiting membrane removal or not, t-PA retinal venous thrombelysis, oph-thalmic artery thrombolysis and so on. However, the most of the therapeutic methods are controversial, the action mechanism of some therapies are still not clear, and their complications should be taken attendtion seriously. So in the future it is necessary to conduct multiple centre prospective randomized controlled trials for evaluating the role of different surgical therapies for CRVO. (Ophthalmol CHN, 2009, 18: 217-220)

Retinal Choroidal Collateral Circulation After Radial Optic Neurotomy for Central Retinal Vein Occlusion

PURPOSE: To evaluate the incidence of retinal choroidal collateral circulation after radial optic neurotomy (RON) with central retinal vein occlusion (CRVO) patients and to correlate these collaterals with changes in visual acuity. METHODS: We conducted a retrospective study of 17 eyes of 17 consecutive patients diagnosed with CRVO who underwent RON after a standard three port-vitrectomy. Fundus examination and, FAG were performed to evaluate the incidence of retinal choroidal collateral circulation according to preoperative best corrected visual acuity. We evaluated changes in best corrected visual acuity according to chorioretinal circulation formation. RESULTS: Retinochoroidal shunts developed in 9 eyes (52.9%) at the site of radial optic neurotomy. The group whose initial visual acuity was better than 0.02 (72.7%) developed more shunts than the group whose initial visual acuity was under 0.02 (16.7%) (P=0.043). Changes in visual acuity were highly correlated with the development of collaterals from the retinal to choroidal circulation (P=0.008). CONCLUSIONS: Patients whose that initial visual acuity is better than 0.02 have more retinal choroidal collaterals. Surgical induction of retinochoroidal venous anastomosis may result in visual acuity improvement. Randomized studies are needed to compare the current study modality with the natural course of central retinal vein occlusion.

Clinical Efficacy of Radiofrequency Cervical Zygapophyseal Neurotomy in Patients with Chronic Cervicogenic Headache

The purpose of the present study was to assess the clinical efficacy of radiofrequency (RF) cervical zygapophyseal joint neurotomy in patients with cervicogenic headache. A total of thirty consecutive patients suffering from chronic cervicogenic headaches for longer than 6 months and showing a pain relief by greater than 50% from diagnostic/prognostic blocks were included in the study. These patients were treated with RF neurotomy of the cervical zygapophyseal joints and were subsequently assessed at 1 week, 1 month, 6 months, and at 12 months following the treatment. The results of this study showed that RF neurotomy of the cervical zygapophyseal joints significantly reduced the headache severity in 22 patients (73.3%) at 12 months after the treatment. In conclusion, RF cervical zygapophyseal joint neurotomy has shown to provide substantial pain relief in patients with chronic cervicogenic headache when carefully selected.

Radiofrequency Neurotomy of the Gray Ramus Communicans for Lumbar Osteoporotic Compression Fracture

OBJECTIVE: The aim of this study was to determine the efficacy of percutaneous radiofrequency neurotomy(RFN) of grayramus communicans nerve in patients suffering from severe low back pain due to osteoporotic compression fracture. METHODS: Twenty two patients with lumbar osteoporotic compression fracture who had intractable back pain for less than two weeks and were performed with RFN at L1-L4 from May 2004 to December 2005 were retrospectively analyzed. Clinical outcome using visual analogue scale(VAS) pain scores and modified MacNab's grade was tabulated. Complications related to the procedure were assessed. RESULTS: Twenty-two female patients (age from 63 to 81 years old) were included in this study. The mean VAS score prior to RFN was 7.8, it improved to 2.6 within postoperative time of 48 hours, and the mean VAS score after 3 months was 2.8, which was significantly decreased. Eighteen of 22 patients were graded as excellent and good according to modified MacNab's criteria at final follow up. All patients recovered uneventfully, and the neurologic examination revealed no deficits. Two patients showing poor results worsened in symptom. Percutaneous was performed eventually resulting in symptom improvement. There were no significant complications related to the procedure such as sensory dysesthesia, numbness or permanent motor weakness. CONCLUSION: RFN is safe and effective in treating the painful osteoporotic compression fracture. In patients with intractable back pain due to lumbar osteoporotic compression fracture, RFN of gray ramus communicans nerve should be considered as a treatment option prior to vertebroplasty.

Microsurgical Selective Obturator Neurotomy for Spastic Hip Adduction

OBJECTIVE: Cerebral palsy may induce harmful spastic hip adduction. We report the result of microsurgical selective obturator neurotomy, performed on 12 spastic hip adductions of 6 patients, followed clinically for at least 26 months postoperatively. METHODS: Microsurgical selective obturator neurotomies, involving microsurgical resection of the anterior obturator nerve branches were performed on 6 patients from January 2000 through June 2003. All patients presented with the inability to sit and 2 patients complained of persistent, intractable pain. We used intraoperative bipolar stimulation to identify selected motor branches. RESULTS: The procedure was performed bilaterally in all patients. In the 3 patients in whom contractures were present, microsurgical selective obturator neurotomies were accompanied by an additional tenotomy of the adductor muscles. Selective tibial neurotomy was performed on three of six patients who originally presented with a spastic ankle. Postoperatively, all spastic hip adductions were corrected more than 60 degrees in passive abduction-adduction amplitude. However, one patient who did not receive active postoperative physiotherapy demonstrated a decreased passive abduction-adduction amplitude upon follow-up. There were no surgical complications. CONCLUSION: We think microsurgical selective obturator neurotomy may be an effective procedure in the treatment of localized, harmful spastic hip adduction after failure of well conducted conservative treatment. As muscular contractions are often associated with spasticity of the hip adductors, an adjunctive tenotomy may be an option. Comprehensive postoperative physiotherapy is essential to improve long-term results.

Lumbar Sympathetic Radiofrequency Neurotomy in Plantar Hyperhidrosis

OBJECTIVE: Surgical treatment of focal plantar hyperhidrosis is often unsatisfactory compared to palmar hyperhidrosis. The purpose of this study is to evaluate the effect of lumbar sympathetic radiofrequency neurotomy on plantar hyperhidrosis. METHODS: From February 2004 to December 2005, 10 patients (mean age 24.3 male 1, female 9) with the clinical diagnosis of plantar hyperhidrosis were treated by bilateral lumbar sympathetic radiofrequency neurotomy of L3 and L4. Patients' symptom relief, satisfactory rate and side effects related to the procedure were analyzed. RESULTS: Radiofrequency neurotomy was effective in the treatment of focal plantar hyperhidrosis showing excellent (more than 75% improved) outcome in 70% of the patients and good (more than 50% improved) in 30%. Complications related to the surgical procedure, such as sensory dysesthesia and compensatory hyperhidrosis were not detected in any case. CONCLUSION: The use of radiofrequency neurotomy to ablate the lumbar sympathetic ganglion is a safe and effective treatment option for patients with plantar hyperhidrosis.

The Effect of Radiofrequency Neurotomy on Chronic Low Back Pain

STUDY DESIGN: A prospective study. PURPOSE: To determine the success rate and duration of relief of radiofrequency neurotomy for lumbar facet joint pain. OVERVIEW OF LITERATURE: There is a lack of effective treatment for chronic low back pain. Radiofrequency denervation appears to be an emerging technology, with substantial variations in use. METHODS: Fifty-eight patients underwent radiofrequent neurotomy on the posterior primary ramus for chronic low back pain. All patients with low back pain of more than 3 months duration, with or without non-radicular radiation to the buttock and hip, were included in the study. From October 2005 to December 2006, eligible patients underwent a standardized diagnostic work-up, which included the use of a visual analog scale (VAS), physical examination, review of imaging studies, and diagnostic blockades. Pain relief was assessed on the third day, and at 3 months and 6 months post-treatment, using the visual analog scale. RESULTS: There were 44 women and 14 men included in the study. The mean age was 57.7 years (range, 20~80 years). Radiofrequency neurotomy denervated three segments and a bilateral lesion in all patients. The visual analogue scale (VAS) scores on the third day (mean VAS score: 1.48) and 3 months (mean VAS score: 1.79) after treatment decreased significantly when compared with the pre-treatment scores (mean VAS score: 6.56). However, the final values of the VAS scores after 6 months were slightly increased as compared to the VAS scores measured at the beginning of the study (mean VAS score: 2.91). No cases of infection, new motor deficits, or new sensory deficits were identified. CONCLUSIONS: We suggest that radiofrequency neurotomy offers an effective palliative management of lumbar facet pain. However, there is limited evidence that radiofrequency neurotomy offers short-term relief for chronic low back pain. Further high-quality randomized controlled trials are needed with larger patient numbers and more data on the long-term effects, for which current evidence is inconclusive.