Thermocoagulation of the vertebral joints (facet coagulation)
This therapy of the facet syndrome is a minimally invasive surgical procedure. Under CT or image converter control, an electrode is placed on the vertebral joint and, after ensuring the correct position, is heated to 75-80°C for 90 seconds by a radiofrequency device. In this way, the small nerves supplying the joint (pain transmission) are cooked.
After the normal deep wound pain has elapsed, a varying degree of painlessness or analgesia is achieved. Even with this therapy of the facet syndrome, the success is difficult to predict. Pain relief can last for months to years, although generally the therapeutic effect diminishes with increasing time.
A repetition of the therapy is possible. The frequency of pain recurrence is particularly pronounced in the first 6 months. Unfavorable prognostic factors are:
- Ongoing insurance procedure
- Previous spine surgery
- Ineffective facet injectors
DIAM (Device for Intervertebral Assisted Motion)
If conservative therapy measures for facet syndrome are not successful, the implantation of a dynamic implant that supports the function of the vertebral joints may be considered. This therapy is a relatively new procedure, which has proven its suitability in various cases. The surgeon should make a final evaluation of the conditions under which implantation is promising.
A general recommendation may seem too early.The DIAM implant is an H-shaped polyethylene mesh with a silicone core. In this therapy, it is placed between the spinous processes of two vertebral bodies in a relatively small open spinal surgery and fixed in place. The function of this implant is to limit the range of motion of the vertebral joints in flexion and extension. Since the implant is implanted under pretension between the spinous processes, pressure is simultaneously relieved from the vertebral joints.
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