title: Radiofrequency lumbar facet denervation: a comparative study of the reproducibility of lesion size after 2 current radiofrequency techniques.
abstract: OBJECTIVE
  Radiofrequency facet denervation procedures are widely used for the treatment of chronic low-back pain. Currently, both temperature-controlled and voltage-controlled techniques are used. In this combined in vivo and in vitro study, the electrophysiologic consequences and the effects on lesion size of these techniques were determined.
  
  
  METHODS
  Thirty-three patients were randomly assigned to receive a lumbar radiofrequency facet denervation by using either temperature-controlled (80 degrees C, 60 seconds) or voltage-controlled (20 V, 60 s) mode. Electrophysiologic parameters in both groups during radiofrequency lesioning were registered. Observed differences between electrodes were quantified and interpreted, using lesion-size data from egg-white experiments.
  
  
  RESULTS
  Seventeen patients in the temperature group were treated with a total of 55 radiofrequency lesions, all considered technically adequate. In the voltage-controlled group, 16 patients received 63 lesions. Of these, 44 (69.8%) procedures were found to be technically inadequate. Voltage-controlled radiofrequency lesioning resulted in uncontrollable fluctuations of temperature, with resultant uncontrollable variations in lesion size. Temperature-controlled mode created reproducible lesion sizes.
  
  
  CONCLUSIONS
  There is no consistent relation between voltage and the temperature obtained during radiofrequency lumbar facet denervation. Temperature-controlled radiofrequency lesioning is preferred to create reproducible lesion sizes.
authors.affiliation: Centre for Perioperative Medicine, Anesthesiology, and Pain Clinic, University Medical Centre Utrecht, Utrecht, The Netherlands. ejbuijs@kabelfoon.nl
authors.forename: Evert J
authors.initials: EJ
authors.lastname: Buijs
authors.forename: Roelof M A W
authors.initials: RM
authors.lastname: van Wijk
authors.forename: Jos W M
authors.initials: JW
authors.lastname: Geurts
authors.forename: Rolf R
authors.initials: RR
authors.lastname: Weeseman
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stolker
authors.forename: Gerbrand G
authors.initials: GG
authors.lastname: Groen
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D003714:Denervation / Q000379:methods*; D004566:Electrodes; D004594:Electrophysiology / Q000379:methods; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D017116:Low Back Pain / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000294:innervation* / Q000601:surgery; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D015203:Reproducibility of Results; D013696:Temperature; D013997:Time Factors; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000294:innervation* / Q000601:surgery*