title: Optimal Temperature for Radiofrequency Ablation of Lumbar Medial Branches for Treatment of Facet-Mediated Back Pain.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pain Management, Cleveland Clinic, Cleveland, Ohio, U.S.A.|Evidence Based Pain Medicine Research, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Shrif
authors.initials: S
authors.lastname: Costandi
authors.affiliation: Department of Pain Management, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Garcia-Jacques
authors.affiliation: Department of Pain Management, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Teresa
authors.initials: T
authors.lastname: Dews
authors.affiliation: Department of General Anesthesiology, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Michael
authors.initials: M
authors.lastname: Kot
authors.affiliation: Department of General Anesthesiology, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Kevin
authors.initials: K
authors.lastname: Wong
authors.affiliation: Evidence Based Pain Medicine Research, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Gerges
authors.initials: G
authors.lastname: Azer
authors.affiliation: Ohio State University, Columbus, Ohio, U.S.A.
authors.forename: Jasmyn
authors.initials: J
authors.lastname: Atalla
authors.affiliation: Oakland University, Rochester, Michigan, U.S.A.
authors.forename: Michael
authors.initials: M
authors.lastname: Looka
authors.affiliation: Case Western Reserve University, Cleveland, Ohio, U.S.A.
authors.forename: Elie
authors.initials: E
authors.lastname: Nasr
authors.affiliation: Department of Pain Management, Cleveland Clinic, Cleveland, Ohio, U.S.A.|Evidence Based Pain Medicine Research, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Nagy
authors.initials: N
authors.lastname: Mekhail
keywords: facet denervation; facet-mediated back pain; low back pain; medial branch; neurotomy; optimal temperature; outcomes; radiofrequency ablation