BACKGROUND: Lumbar spinal stenosis is a debilitating condition commonly seen in older adults. Hypertrophy of the ligamentum flavum significantly contributes to the pathology. Although epidural injections are commonly used when conservative measures fail, they often provide only transient relief. Radiofrequency lesioning of fibrotic tissue can result in a reduction in size. We report radiofrequency lesioning of the ligamentum flavum and the outcomes.

CASE REPORT: We present 2 patients with neurogenic claudication due to lumbar spinal stenosis and ligamentum flavum hypertrophy. They had disabling back pain and bilateral leg pain that was not adequately relieved by medications. Both underwent image-guided radiofrequency lesioning of the ligamentum flavum. The patients experienced clinically significant improvement in pain and functional scores at 4 weeks after treatment.

CONCLUSIONS: Image-guided radiofrequency lesioning of hypertrophied ligamentum flavum may be a minimally invasive technique that provides symptomatic relief in patients with lumbar spinal stenosis who are poor surgical candidates.

KEYWORDS: Spinal stenosis, case report, ligamentum flavum, radiofrequency ablation