According to Wilhelm
The denervation according to Wilhelm describes a surgical technique that is supposed to help people with tennis elbow to relieve their pain. With tennis elbow, the pain is mainly at the tendon attachment points of the elbow bone. By interrupting the transmission of stimuli from two pain-conducting nerves in this area, the pain can be reduced. Both nerves are branches of the radialis nerve. If the operation is performed correctly, there is no loss of muscle strength or motor skills, i.e. movement ability and execution, after the operation.
Knee
Cutting through the sensitive, pain-conducting nerve fibres of the knee is the final step in the treatment of chronic knee pain that does not improve. The reason for such severe pain is often joint degeneration, i.e. knee joint arthrosis. As a rule, an attempt is first made to replace the “broken” knee with a knee prosthesis.
If the pain then continues or even worsens, denervation can be a proven means of relieving the pain. The responsible nerve cords run outside the joint. Therefore, no further intervention in the form of arthroscopy or similar at the knee joint is necessary.
The skin on the knee joint is opened in a small, gentle operation using a small skin incision, the responsible nerves are detected and the transmission is interrupted. The nerves that supply the muscles are left in place and not destroyed, so that the mobility of the knee joint and the strength of the leg is not impaired after the operation. Many patients even report improved mobility due to the subsequent freedom from pain.
Sacroiliac joint
The sacroiliac joints (ISG) connect the spine to the pelvis. Some diseases, including ankylosing spondylitis, are accompanied by inflammatory and degenerative changes in the area of these joints, which can lead to severe pain, especially when moving. At first, an attempt should be made to counteract the pain by means of physiotherapy and the administration of painkilling medication. If this therapy does not bring any improvement in the long term, denervation of the pain-conducting sacroiliac joint nerves can lead to an improvement in the pain situation. These fibres are sclerosed and thus switched off in a small operation, known in the technical language as radiofrequency neurotomy.
Facet
The facet joints are used for the articulated connection between two vertebral bodies. Each vertebral body has two upper and two lower facet joint surfaces on the left and right side, respectively, whereby the upper joint surface of a vertebral body forms the joint connection with the lower one of the vertebral body above. Due to their frequent and intensive use, these small joints can also be affected by inflammatory processes and degenerative changes, i.e. facet joint arthrosis.
This leads to severe pain, which often occurs in connection with movement and stretching of the spine. In the beginning, physiotherapy, painkilling medication and the injection of local anaesthetics and cortisone can help to relieve the pain. If, however, the pain becomes chronic and cannot be reduced in intensity even by medication, facet degeneration, i.e. cutting the pain-conducting fibres at the small joints, can be the way to freedom from pain. This minor procedure can in the majority of cases even be carried out on an outpatient basis. The pain nerve nerves are detected with a needle pierced through the skin and sclerosed with a current applied over it.
