الفهرس 
AnatomyOnly 14 pages are availabe for public view
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Abstract
This study reviewed the surgical anatomy of lumbar spine including the anatomy of the lumbar vertebrae, intervertebral disc and the spinal cord. The biomechanics of the lumbar spine were briefly discussed. The study also reviewed the measures of conservative management of chronic low back pain. Also principles of radiofrequency and its modes had been discussed. Radiofrequency (RF) is a medical procedure mainly used to reduce pain. An electrical current produced by a radio wave is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area. In the last 5 years, an important field of application of this procedure is the spine and its pathologies as in facet joint pain, sacroiliac pain and discogenic pain.The purpose of this study is to describe the effect of radiofrequency in reducing the intensity of chronic low back pain and its role in increasing the daily activity of the patients.All patients were subjected to history taking, complete physical and neurological examination, radiological investigations, laboratory investigations and special RF neurotomy maneuver according to type of back pain as mentioned before .Visual analogue score and daily living activity measured before, immediately after one month and three months after the procedure.In the present study, out of 40 patients constituting this study,14 (35%) were <50 years, 16 (40%) were 50-60 years and 10 (25%)were >60 years. Females constituted 75% of the patients of this study while males constituted 25% with a female to male ratio equal to 3:1.Prevalence of low back pain was mainly in females from 50 years up to 60 years.In our study we had 20 patients were complaining from low back pain originating from facet ,10 patients were from 50-60 year ,6 patients were more than 60 years ,4 patients were less than 50 years .17 patients were female. 6 patients were complaining from right side, 8 patients were complaining from left side and 6 patients were complaining from bilateral side.12 patients had spine surgery before intervention.
Mean value of pain score before RF in facet pain group were(8.100 ± 0.718), (4.300± 1.380), (3.900± 1.971), and (3.900± 2.315)before RF, immediately after 1, and 3months of RF respectively, there was a highly significant decrease in VAS pain score (p <0.001)immediately, after1 and after 3 months as compared to before RF also70% of patient attained normal daily activity immediately, after 1 month and after 3 months when compared to before the maneuver (p <0.001).In our study 14 (70%) patients from 20 patients with facet pain had satisfactory results with pain score VAS less than 5 and increase in daily activity at the end of the study while 6 (30%) patients had unsatisfactory result. Also there was statistical highly significant decrease in analgesic used immediately, after 1 and 3 months when compared to patient’s base line this indicated efficacy of RF in relieving symptoms (P<0.001).The current study the number of patients with sacroiliac joint (SIJ) pain were 12 patients, 8 patients of them were less than 50 years and 4 patients were more than 50 years, 5 patients were male and 7 patients were female, 4 patients complained from right side, 6 patients complained from left side, 4 patients complained from right side and 2
patients complained from both side also 2 patients had previous spine surgery.Mean value of pain score in SIJ pain were (7.667 ± 0.778), (5.500±
0.798), (4.667± 1.155), and (4.417± 0.996) before RF, immediately, after 1 month, and 3months of RF respectively, there was highly significant decrease in VAS pain score (p <0.001) immediately, after1 and 3 months as compared to before RF, also 100% of patients attained normal daily activity immediately after 1 month ,3 months when compared to before the maneuver (p < 0.001).In the present work, pain was considered satisfactory relief when VAS score ≤ 5 according to that 75% of patients with sacroiliac
pain type had satisfactory pain relief and the other 25% had unsatisfactory decrease in pain score. Also there was statistical highly significant decrease in analgesic used immediately, after 1 and 3
months when compared to patient’s base line this indicated efficacy of RF in relieving symptoms (P<0.001). In our study the numbers of patients with discogenic pain type
were 8 patients, 4 of them were from 50-60 years,2 patients below 50years and 2 patients more than 60 years. 6 patients were female. 4
patients had lesion at level L5-S1. Mean value of pain score were (7.250 ± 0.463), (4.500± 0.535), (3.250± 0.463), and (4.125± 1.553),before RF, immediately after 1 month , and 3 months of RF respectively, there was highly significant decrease in VAS pain score (p <0.001) immediately, after1 month ,and 3 months as compared to before RF . Also 100% of patient attained normal daily activity immediately after 1 month and 3 months when compared to before the maneuver (p < 0.001).