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Take the pain

The VERTEBRIS denervation system for endoscopically controlled facet and sacroiliac joint denervation offers a holistic and impressive system solution in combination with the 4Mhz Radioblator RF generator.

This system improves the success of treatment with visually controlled and precisely focused application of instrumentation and RF energy. The medial and, optionally, lateral branch of the dorsal ramus can be visualized using endoscopically controlled denervation, safely resected and coagulated.

Facet Joint Denervation

The small vertebral joints (facet joints) are surrounded by a dense network of nerve fibers. These are irritated by inflammatory processes which occur as part of arthrosis. Direct mechanical irritation is also possible as a result of instability. 

Primary symptoms are therefore back pain or neck pain without significant radiating pain and without neurological deficits. The pain is conducted along the medial branches of the dorsal ramus of the spinal nerve. The objective of endoscopic denervation is to  selectively transect these nerve fibers in order to permanently interrupt the conduction of pain.

The denervation procedure starts with a needle targeting the transverse process under fluoroscopy.  A dilator and working sleeve are inserted, and a shorter spine endoscope is used to visualize the path of the medial branch of the dorsal ramus.  Rongeurs and a  TipControl RF electrode are used to cut and coagulate the medial branch under endoscopic visualization.  This is repeated at as many levels as is required for sufficient pain relief.     

Sacroiliac Joint Denervation

In addition to the facet joints, the sacroiliac joint (SIJ) is frequently a generator of back pain. The mechanisms are similar to those for the facets. The sacroiliac syndrome frequently occurs after stabilization of the spine because the sacroiliac joint is subject to a greater load and this in turn leads to mechanical and inflammatory irritations of the nerves at this joint.

A technique similar to the facet joint denervation can be used, except the targeted branches of the dorsal rami are at the S1-S3 levels where they exit the sacrum.  The same instruments are used as for the facet denervation.

Therapeutic Concept

The centerpiece of effective tissue-preserving coagulation is the Radioblator RF4 radiofrequency generator with a working frequency of 4 MHz.  In combination with the actively articulating TipControl RF Electrode the controlled positioning of the radiofrequency application in the tissue is guaranteed. 

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Education

The RIWOspine education program offers excellent possibilities to learn more about the full-endoscopic technique for spine surgery or interventional percutaneous spine pain therapy.

It is a comprehensive training concept consisting of different modules to implement these innovative techniques successfully in your hospital

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RIWOspine GmbH