Facet joint laser radiation: tissue effects of a new clinical laser application

Klaus Werkmann; Dietmar R. Thal

doi:10.1117/12.230342

19 January 1996 Facet joint laser radiation: tissue effects of a new clinical laser application

Klaus Werkmann, Dietmar R. Thal

Proceedings Volume 2623, Medical Applications of Lasers III; (1996) https://doi.org/10.1117/12.230342
Event: BiOS Europe '95, 1995, Barcelona, Spain

Abstract

Chronic unilateral and bilateral back pain with pseudoradicular symptoms, is a common clinical syndrome, which in many cases can be related to the facet joint syndrome. The pain is caused by mechanical affection of synovial and capsular nerve terminals. Therefore, current therapeutical attempts including physical therapy, intra-articular injection of local anesthetics and steroids and thermocoagulation of the facet joint with a thermocoagulator, are performed. We confirmed laser coagulation of the facet joint. Porcine cadaveric spines were treated immediately after death by intra-articular facet joint laser radiation. With the pulsed Nd:YAG laser (1064 nm) altogether 600 J were applied in three different places 4 mm apart at the top of the facet joint. The results showed that facet joint laser radiation leads to a small (about 1 - 2 mm diameter) lesion restricted to the facet joint cavity and its synovia. Histologically, we found a central carbonization zone and necrosis, including almost the whole cartilage and approximately 0.2 mm of the adjacent bone. These changes are similar to Nd:Yag-laser applications in other skeletal regions. It is suggested that these changes may lead to facet joint denervation by coagulation of the synovial nerve terminals. Cicatration of the laser lesion might cause ankylosis of this joint. In sum, facet joint laser radiation could be an alternative therapeutical tool for lower back pain of the facet joint syndrome type. Therefore, future clinical application of this technique seems to be very promising.

Citation Download Citation

Klaus Werkmann and Dietmar R. Thal "Facet joint laser radiation: tissue effects of a new clinical laser application", Proc. SPIE 2623, Medical Applications of Lasers III, (19 January 1996); https://doi.org/10.1117/12.230342

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