Optimal Temperature for Radiofrequency Ablation of Lumbar Medial Branches for Treatment of Facet-Mediated Back Pain

Shrif Costandi, Mauricio Garcia-Jacques, Teresa Dews, Michael Kot, Kevin Wong, Gerges Azer, Jasmyn Atalla, Michael Looka, Elie Nasr, Nagy Mekhail

Research output: Contribution to journalArticle

4 Scopus citations

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.

Original languageEnglish (US)
JournalPain Practice
DOIs
StateAccepted/In press - 2015
Externally publishedYes

Keywords

  • Facet denervation
  • Facet-mediated back pain
  • Low back pain
  • Medial branch
  • Neurotomy
  • Optimal temperature
  • Outcomes
  • Radiofrequency ablation
  • Radiofrequency ablation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Costandi, S., Garcia-Jacques, M., Dews, T., Kot, M., Wong, K., Azer, G., Atalla, J., Looka, M., Nasr, E., & Mekhail, N. (Accepted/In press). Optimal Temperature for Radiofrequency Ablation of Lumbar Medial Branches for Treatment of Facet-Mediated Back Pain. Pain Practice. https://doi.org/10.1111/papr.12346