Radiofrequency thermotherapy for low back pain

  Chronic lumbar hip pain induced by the posterior branch of the lumbar spinal nerve is caused by a herniated lumbar disc, bony fibular canal compression of the posterior branch of the lumbar spinal nerve, or lumbar myofasciitis, resulting in a series of painful discomfort in the area of its innervation, manifested as pinprick-like or involvement-like pain in the affected lumbar back, which may radiate to the buttocks, posterior thigh or anterior thigh. There are various treatments for this disease at home and abroad, including conservative treatment with nonsteroidal analgesic and anti-inflammatory drugs, physical therapy, and surgical treatment with radiofrequency thermotherapy of the posterior branch of the spinal nerve.  The patient is placed in a prone position with both upper extremities parallel to the trunk and routinely disinfected and toweled. The target point is the most concave point of the lumbar articular column under standard lumbar orthoptic fluoroscopy, and the actual needle entry point is approximately 2 cm below each of its external points. The needle tip is turned inward and punctured toward the target point until it contacts the hard bone of the synovial joint. At this point, the needle tip is turned outward and slides over the outer edge of the articular eminence and continues to advance. The C-arm machine is turned into a standard lateral fluoroscopy to monitor the depth of needle entry and to ensure that the needle tip does not cross the anterior edge of the articular column to avoid injury to the anterior branch of the spinal nerve. After successful puncture, the radiofrequency electrode was inserted for electrical stimulation test: when the switching test frequency was 50 Hz, sensory test voltage was 0.3~0.5 V, test frequency was 2 Hz, and motor test voltage was 0.6~0.8 V, the patient reported that the pain site was exactly the same as before surgery, and the vertical spinal muscle throbbing appeared, the target nerve location was clarified, then 2% lidocaine 0.3 ml was injected, and the standard radiofrequency was turned on after waiting for 1 minute. After waiting for 1 minute, the standard radiofrequency destruction mode was turned on, and two radiofrequency cycles of heat therapy were given at 40℃ for 60 seconds. The procedure was repeated if the patient’s low back pain involved bilateral or multiple posterior spinal nerve branches. The patient was returned to the ward 15 minutes after the end of the treatment without any abnormalities.  This method is a high-end application in the field of neuroscience, a biological engineering technique that relies on point stimulation or pharmacological means to improve the symptoms and quality of life of the affected population through implantable or non-implantable techniques.