title: Long-term follow-up of cervical facet medial branch radiofrequency treatment with the single posterior-lateral approach: an exploratory study.
abstract: BACKGROUND
  Over 50% of patients presenting to pain clinic with neck pain have the cervical facet joints as the source of pain. Radiofrequency (RF) treatment of the medial branch, innervating the facet joint, is a therapeutic option. The objectives of this study were to evaluate the therapeutic effect and its duration of RF treatment, using the single posterior-lateral approach in patients suffering from facet joint degeneration and to identify predictors for a long-term effect.
  
  
  METHODS
  Of the 130 consecutive patients with axial neck pain referred to the University Pain Center Maastricht, 67 fulfilled the inclusion criteria. The therapeutic effect was measured using the Patients' Global Impression of Change (PGIC) scale. Retrospective data were made complete using newly collected PGIC follow-up data. A Kaplan-Meier curve evaluated the long-term therapeutic effect. Possible predictors of outcome were evaluated.
  
  
  RESULTS
  Two patients refused to participate and in the remaining 65 patients, overall pain relief was reported in 55.4% at 2-month follow-up. Moderately, important change of improvement and substantial change of improvement were seen in 50.8% of patients. At 3-year follow-up, 30% still reported pain reduction. Spinal treatment level was the only predictor found.
  
  
  CONCLUSIONS
  Radiofrequency treatment of the cervical facet joints using a single posterior-lateral approach is a promising technique in patients with chronic neck pain due to facet degeneration. The short-term and long-term therapeutic effects of this intervention justify a randomized controlled trial to estimate the efficacy of cervical facet joint RF treatment in a chronic neck pain population.
authors.affiliation: Department of Anaesthesiology and Pain management, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Anaesthesiology, Pain Management and Intensive Care, Amphia Hospital, Breda, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: van Eerd
authors.forename: Nelleke
authors.initials: N
authors.lastname: de Meij
authors.forename: Erik
authors.initials: E
authors.lastname: Dortangs
authors.forename: Alfons
authors.initials: A
authors.lastname: Kessels
authors.forename: Jan
authors.initials: J
authors.lastname: van Zundert
authors.forename: Arno
authors.initials: A
authors.lastname: Lataster
authors.forename: Jacob
authors.initials: J
authors.lastname: Patijn
authors.forename: Maarten
authors.initials: M
authors.lastname: van Kleef
mesh_terms: D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D003714:Denervation / Q000295:instrumentation / Q000379:methods*; D005471:Fluoroscopy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D019547:Neck Pain / Q000175:diagnosis / Q000601:surgery*; D010147:Pain Measurement / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000473:pathology / Q000601:surgery*
keywords: Neck pain; cervical medial branch; facet joint; longitudinal study; radiofrequency ablation; zygapophyseal joint