Symptom Recurrence Pattern after Radiofrequency Thermocoagulationfor Facet Joint Syndrome

OBJECTIVE: To investigate the rates and mean duration of symptom recurrence after repeated radiofrequency thermocoagulations of the lumbar medial branch nerves for facet joint syndrome. METHOD: Medical records of 284 patients who had consecutive radiofrequency thermocoagulations for facet joint syndrome were reviewed. Responses of repeated radiofrequency thermocoagulations were compared with the initial radiofrequency thermocoagulation for mean duration of symptom recurrence and visual analogue scale (VAS). RESULTS: Forty-one (14.4%) among the patients who had radiofrequency thermocoagulation for facet joint syndrome were treated with additional radiofrequency thermocoagulation because of symptom recurrence. Thirty-seven patients were treated twice and four patients were treated three times. The mean duration of symptom recurrence of these patients was 7.3 months (2.3~12.3 months). Reduction of the VAS pain scores were significantly lower after repeated radiofrequency thermocoagulations compared with initial radiofrequency thermocoagulation (p<0.05). CONCLUSION: With well-defined diagnostic criteria for facet joint syndrome and a meticulous technique of radiofrequency thermocoagulation, radiofrequency thermocoagulation would be a useful treatment modality for patients with facet joint syndrome.

Incidence of Deep Vein Thrombosis in Spinal Cord Injury

OBJECTIVE: The purpose of this retrospective study was to evaluate the incidence of deep vein thrombosis (DVT) in spinal cord injury (SCI). METHOD: We analyzed the incidence of DVT and factors that alter its risk in 263 SCI patients. The injury status of each SCI subject was categorized as either motor complete or motor incomplete and either quadriplegic or paraplegic. The cause of injury was categorized as either traumatic or nontraumatic. Duplex ultrasound was performed in the clinically DVT suspected patients. No patient had been started on anticoagulant prophylaxis prior to diagnosis of DVT. RESULTS: Fifteen patients (5.7%) had a diagnosed DVT and one patient (0.4%) had a diagnosed pulmonary embolism. Motor complete lesion and quadriplegic status were better predictors of DVT than motor incomplete lesion and paraplegic status. Cause of injury and existence of spasticity were not statistically correlated with the incidence of DVT. Accuracy of clinical diagnosis was 45.4%. All cases of the diagnosed DVT was located proximal veins (iliac and femoral veins). Ten of 15 DVTs (66.6%) were detected earlier than 2 months after SCI. CONCLUSION: Incidence of DVT in SCI patients were 5.7%. Motor complete lesion and quadriplegic status were suggested as significant predictors of DVT in SCI patients.