Optimal Temperature for Radiofrequency Ablation of Lumbar Medial Branches for Treatment of Facet‐Mediated Back Pain. Issue 8 (15th September 2015)

• Record Type: Journal Article
• Authors: Costandi, Shrif; Garcia‐Jacques, Mauricio; Dews, Teresa; Kot, Michael; Wong, Kevin; Azer, Gerges; Atalla, Jasmyn; Looka, Michael; Nasr, Elie; Mekhail, Nagy
• Is Part Of: Pain practice. Volume 16:Issue 8(2016:Nov.)
• Page Start: 961
• Page End: 968
• Publication Date: 2015-09-15
• Subjects: radiofrequency ablation -- radiofrequency ablation -- facet‐mediated back pain -- low back pain -- optimal temperature -- medial branch -- facet denervation -- neurotomy -- outcomes; Pain -- Treatment -- Periodicals; 616.0472
• DOI: 10.1111/papr.12346
• Languages: English
• ISSNs: 1530-7085

Abstract

Abstract: Background: Radiofrequency ablation (RFA) of the medial branch nerves that innervate the facet joints is a well‐established treatment modality; however, studies to determine the optimal radiofrequency ablation temperature are lacking. A wide range (70 to 90°C) has been used. This study aimed to compare outcomes with two set temperatures for the lumbar facet medial branch ablation, 90 and 80°C. Methods: This retrospective study compared the degree of patient self‐reported functional improvement relief, postoperative opioid dose changes, as well as duration among lumbar facet medial branch (RFA) patients who had the procedures performed at 80 or 90°C. Results: Patients who underwent the procedure at 90°C had 3.1 (95% CI 1.7, 6.5) times the odds ( P = 0.0004) of reporting functional improvement of at least 50% when compared to those who underwent neurotomy at 80°C. For self‐reported functional improvement greater or equal to 75%, the results were sustained with an odds ratio of 2.8 (95% CI 1.2, 5.7) favoring those with 90°C temperature neurotomy ( P = 0.002). Conclusion: There seems to be significant functional improvement associated with temp of 90°C compared to 80°C, with no added risk of complications. Randomized controlled studies are warranted.