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

3 Citations (Scopus)

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

Fingerprint

Back Pain
Temperature
Zygapophyseal Joint
Opioid Analgesics
Therapeutics
Retrospective Studies
Odds Ratio

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

Cite this

Costandi, S., Garcia-Jacques, M., Dews, T., Kot, M., Wong, K., Azer, G., ... 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

Optimal Temperature for Radiofrequency Ablation of Lumbar Medial Branches for Treatment of Facet-Mediated Back Pain. / Costandi, Shrif; Garcia-Jacques, Mauricio; Dews, Teresa; Kot, Michael; Wong, Kevin; Azer, Gerges; Atalla, Jasmyn; Looka, Michael; Nasr, Elie; Mekhail, Nagy.

In: Pain Practice, 2015.

Research output: Contribution to journalArticle

Costandi, S, Garcia-Jacques, M, Dews, T, Kot, M, Wong, K, Azer, G, Atalla, J, Looka, M, Nasr, E & Mekhail, N 2015, '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
Costandi, Shrif ; Garcia-Jacques, Mauricio ; Dews, Teresa ; Kot, Michael ; Wong, Kevin ; Azer, Gerges ; Atalla, Jasmyn ; Looka, Michael ; Nasr, Elie ; Mekhail, Nagy. / Optimal Temperature for Radiofrequency Ablation of Lumbar Medial Branches for Treatment of Facet-Mediated Back Pain. In: Pain Practice. 2015.
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