title: Effect of pulsed radiofrequency in treatment of facet-joint origin back pain in patients with degenerative spondylolisthesis.
abstract: BACKGROUND
  Degenerative spondylolisthesis is a well-recognized source of low back pain mainly induced by facet joint pain. Pulsed radiofrequency (PRF) allows heat dissipation, thus producing a temporary injury that affects only type C fibers responsible for pain conduction.
  
  
  OBJECTIVE
  We attempted to test whether PRF is a better choice for facet pain due to spondylolisthesis compared to routine steroid injection.
  
  
  METHODS
  Patients were randomly assigned to one of two groups: group one received pulsed RF, and group 2 received injection by steroids (triamcinolone) and bupivacaine.
  
  
  METHODS
  Multiple outcome measures were utilized which included the numeric rating scale (NRS), the Oswestry Disability Index (ODI), satisfaction status, and analgesic intake with assessment at 3, 6, and 12 months post-treatment. Significant pain relief was defined as 50% or more, whereas significant improvement in disability score was defined as reduction of 40% or more.
  
  
  RESULTS
  Eighty patients were enrolled in the study and were divided into the two groups of study. PRF significantly reduced NRS at 6-month follow-up compared to steroid + bupivacaine. 75.6 ± 14.3% at pre-treatment and 19.3 ± 9.5% at 6 months (p = 0.001) in PRF group. The mean ODI is depicted in two groups of study (Fig. 1). Interestingly, ODI% was significantly lower in PRF group at 12 weeks and 6 months compare to steroid + bupivacaine group (p = 0.022 and 0.03, respectively), but it was not significantly different at 6 weeks (p = 0.31). Proportion of patients who did not require analgesics were significantly higher in PRF group compared to other group (p = 0.001) in Log-rank (Mantel-Cox) test.
  
  
  CONCLUSIONS
  Our results demonstrated that the application of PRF might be more effective than steroid and bupivacaine injection in decreasing back pain due to degenerative facet pain and improvement in function of patients.
authors.affiliation: Department of Anesthesiology, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Fereshteh St, Tehran, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Hashemi
authors.forename: Morteza
authors.initials: M
authors.lastname: Hashemian
authors.forename: Seyed Amir
authors.initials: SA
authors.lastname: Mohajerani
authors.forename: Giv
authors.initials: G
authors.lastname: Sharifi
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage; D018771:Arthralgia / Q000188:drug therapy / Q000628:therapy; D002045:Bupivacaine / Q000008:administration & dosage; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D036421:Nerve Fibers, Unmyelinated / Q000187:drug effects; D010147:Pain Measurement; D061208:Pulsed Radiofrequency Treatment / Q000379:methods*; D013168:Spondylolisthesis / Q000150:complications*; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage*; D021801:Zygapophyseal Joint / Q000187:drug effects
chemical_list: D000779:Anesthetics, Local; D005938:Glucocorticoids; D014221:Triamcinolone; D002045:Bupivacaine