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Case report

Spinal dorsal rami injection and radiofrequency neurolysis for low back pain caused by osteoporosis-induced thoracolumbar vertebral compression fractures

Linqiu Zhou, Jeffrey Zhou
Department of Rehabilitation Medicine, Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, USA.
DOI: 10.2340/20030711-1000056

Abstract

Objective: Low back pain caused by osteoporosis-induced thoracolumbar vertebral compression fractures is a common debilitating disorder. The aims of this study were to determine the accuracy and efficacy of spinal dorsal ramus injection and radiofrequency neurolysis for pain reduction in patients with this condition.
Methods: This study was a retrospective chart review of 46 patients with low back pain caused by osteoporosis-induced thoracolumbar vertebral compression fractures. All patients had been treated with spinal dorsal ramus injection with mixed Sensorcaine (Fresenius Kabi, USA) and Depo-Medrol (Pfizer, USA). In some patients further treatment with radiofrequency neurolysis had been required after the initial injection wore off.
Results: Out of a total of 46 patients, 45 (97.7%) had ≥ 50% reduction in low back pain immediately after injection. After the initial injection wore off, 18 patients remained pain free and 27 required radiofrequency neurolysis. The follow-up period ranged from 60 to 1,440 days (mean 335 days). The intensity of low back pain decreased from 7.09 ± 0.84 (numerical pain scale of 0–10) before treatment to 1.39 ± 1.51 immediately after the injection, and to 0.96 ± 1.36 at the last office visit.
Conclusion: Spinal dorsal ramus injection and radio-frequency neurolysis are effective and accurate therapies for low back pain caused by osteoporosis-induced thoracolumbar vertebral compression fractures.

Lay Abstract

Low back pain caused by osteoporosis-induced fractures is a common debilitating disorder. The fractured vertebra results in a wedge deformity. A small nerve at the back of this fractured vertebra can become stretched causing back pain. Injecting this small spinal nerve with local anaesthetics provides relief of low back pain. In some cases, if pain recurs after the initial injected medication has worn off, burning this nerve with a special needle can provide long-term pain reduction. Both the injection and the burning of the nerve are minimally invasive, effective and accurate procedures.

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