A case of intractable low back pain successfully treated with thermocoagulation for lumbar spondylolysis in adolescent

Abstract

Case: A 17-year-old female basketball player diagnosed with lumbar spondylolysis at another hospital was referred to our clinic. Her back pain worsened after a traumatic injury during a game. She developed persistent left lumbar pain, exacerbated by trunk rotation, difficulty with load-bearing to the left, and claudication. A CT scan of the lumbar spine revealed separation of the fifth lumbar vertebra (right fusion, left pseudarthrosis). Progress: Exercise therapy was ineffective and pain relief with intervertebral joint block was limited. Direct administration of local anesthetics to the separation area provided a short-term relief. Considering lumbar spondylolysis as the main cause of the patient's low back pain, we performed radiofrequency thermocoagulation (60℃ for 6 minutes) to achieve long-term effects. Improvement in lower back pain and alleviation of limping have been observed since the implementation, and there was no deterioration in symptoms even after 6 months. Conclusion: Pseudarthrosis radiofrequency thermocoagulation may improve low back pain in patients with lumbar spondylolysis.