Charles V Burton

Percutaneous RF facet denervation is a valid, low-risk means of treating 'mechanical' pain syndromes in previously unoperated patients with back and/or leg pain. In the series of 126 patients, reported long-term overall success was 42%. With improved technique and patient selection, success rate has increased to 67%. This procedure appears to be increasing in clinical value as a more conservative means of treating certain back pain problems, thus avoiding definitive surgery.

Diagnosis and treatment of low back pain may well have seen more progress in the past five years than in the previous 50. Specific diagnoses can be made by history and physical examination and can often be objectively documented by modern high-resolution computed tomographic scanning of the lumbar spine. A number of innovative conservative treatment modalities show great promise in decreasing the need for surgical intervention. Surgery is indicated only when appropriate conservative ...

Advances in stereotaxic surgery for pain and dyskinesias have stimulated a search for a simple, safe method of producing a predictable, easily controlled, and discrete lesion, and one which, should it prove to be inadequate, could be enlarged without further surgical procedure. An external source of energy which could be accurately focused would be ideal but the available external sources of energy—ultrasonic waves, gamma waves, or the proton beam—are attenuated or dispersed by the ...

When applied under the circumstances of minimal patient risk, as documented in this paper, implanted neuroaugmentive spinal devices are a reasonable means of therapy for selected severe pain problems. With presently developed screening techniques, a 50% good-to-excellent result was obtained in 198 patients predominently consisting of 'failed back surgery syndrome' (94%). These figures represent a very significant improvement in success of treatment for this group of patients when ...