251. A History of the Development of Radiofrequency Neurotomy.
- Author
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Russo M, Santarelli D, Wright R, and Gilligan C
- Abstract
The technique of lumbar medial branch radiofrequency neurotomy for facet joint pain has an intriguing history involving a diverse timeline of medical specialists. This paper aims to chart the pathway that led to its invention and the series of modifications and refinements that have led to modern practice. The story begins with the treatment of World War I soldiers by Nesfield, who used scalpels to cut "trapped" nerves. Inspired by Nesfield's treatment, Rees developed the "percutaneous rhizolysis" technique in 1960. Shealy was the first to use radiofrequency electrodes for denervation of the facet joints, introducing his technique in 1971. Several radiofrequency electrode developments came about from collaborations with Cosman medical device entrepreneurs during the 1970s, including the Shealy Rhizolysis Kit, the Ray Rhizotomy Electrode, and the Sluijter-Mehta Kit. Subsequent dissections of Rees' technique and modification of Shealy's procedure by Bogduk saw the development of "percutaneous lumbar medial branch neurotomy" in 1980 by Bogduk and Long. Bogduk continued to contribute significantly to validation, refinement and acceptance of the technique. In 1998, the technique of pulsed radiofrequency was invented by Sluijter, Cosman, Rittman and van Kleef. Subsequent innovations have consisted of cooled radiofrequency neurotomy, multi-tined cannulae, endoscopic systems, and alternative denervation targets, such as the facet joint capsule. As we pass the first 100 years of the story, we believe there are more chapters to be written on this fascinating subject., Competing Interests: MR provides unpaid consulting for Abbott, Boston Scientific, Mainstay Medical, Medtronic, Nevro, Presidio Medical, Saluda and Stimwave, conducts sponsored research activities for Boston Scientific, Mainstay Medical, Medtronic, Nevro, Presidio Medical and Saluda, and is a stockholder in Freedom Neuro, Lungpacer, Precise Light Surgical and SPR Therapeutics. RW provides consulting for Abbott and reports patents US10716618B2 and US10736688B2 issued to Stratus Medical, LLC. CG provides consulting for Abbott, Iliad Lifesciences, Medtronic and Saluda, conducts research activities for Mainstay Medical and Sollis Therapeutics, reports personal fees from Medtronic, Abbott, Eli Lilly, Saluda, Persica Pharmaceuticals, Iliad Lifesciences, and Expert Witness, and research support paid directly to their institution by Mainstay Medical, outside the submitted work. MR, RW and CG declare no other potential conflicts of interest for this work and declare no consulting, payments received, or other conflicts of interest with any of the companies whose technologies are mentioned in this manuscript. DS has no conflicts of interest for this work to declare., (© 2021 Russo et al.)
- Published
- 2021
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