Radiographic changes induced after cervical facet radiofrequency denervation.
BACKGROUND
Paraspinal infections after zygapophyseal (facet) radiofrequency denervation (RFD) are a serious but rare complication of this procedure. We are aware of only one case report of an epidural abscess after facet joint injection.


OBJECTIVE
To report post-procedure inflammatory changes after cervical facet RFD.


METHODS
Case report.


METHODS
A 35-year-old Caucasian female.


METHODS
Retrospective case review.


RESULTS
The patient underwent cervical RFD and was admitted to the hospital 7 days after her procedure with severe neck pain. Magnetic resonance imaging (MRI) with contrast revealed what appeared to be evidence of a paraspinal muscle abscess although blood tests were negative. She was treated with antibiotic therapy, yet she never developed systemic signs of infection. A follow-up MRI without contrast revealed no evidence of infection, and she was discharged home on hospital day 6. At her first follow-up visit, she was still experiencing scalp pain and paraspinal muscle spasm. During subsequent follow-up visits, she has continued to improve clinically without experiencing signs of infection. Another follow-up MRI 6 weeks after her discharge home revealed persistent minimal left paraspinal enhancement at C2-3, possibly representing post-procedure granulation tissue with no evidence of abscess.


CONCLUSIONS
Post-procedural MRI findings after radiofrequency lesioning can resemble radiographic findings associated with a paraspinal abscess. Patients with radiographic findings consistent with abscess should only be treated if clinical signs or symptoms of systemic infection are present.
Smith
Michelle
M
Pain Management Center, St. Luke's Hospital, 801 Ostrum Street, Bethlehem, PA 18015, USA.
Ferretti
Gene
G
Mortazavi
Steven
S
D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D002574:Cervical Vertebrae / Q000473:pathology* / Q000601:surgery*; D003714:Denervation / Q000009:adverse effects*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009220:Myositis / Q000209:etiology* / Q000473:pathology*; D019547:Neck Pain / Q000601:surgery*