Efficacy of needle-placement technique in radiofrequency ablation for treatment of lumbar facet arthropathy.
BACKGROUND
Many studies have assessed the efficacy of radiofrequency ablation to denervate the facet joint as an interventional means of treating axial low-back pain. In these studies, varying procedural techniques were utilized to ablate the nerves that innervate the facet joints. To date, no comparison studies have been performed to suggest superiority of one technique or even compare the prevalence of side effects and complications.


METHODS
A retrospective chart review was performed on patients who underwent a lumbar facet denervation procedure. Each patient's chart was analyzed for treatment technique (early versus advanced Australian), preprocedural visual numeric scale (VNS) score, postprocedural VNS score, duration of pain relief, and complications.


RESULTS
Pre- and postprocedural VNS scores and change in VNS score between the two groups showed no significant differences. Patient-reported benefit and duration of relief was greater in the advanced Australian technique group (P=0.012 and 0.022, respectively). The advanced Australian technique group demonstrated a significantly greater median duration of relief (4 months versus 1.5 months, P=0.022). Male sex and no pain-medication use at baseline were associated with decreased postablation VNS scores, while increasing age and higher preablation VNS scores were associated with increased postablation VNS scores. Despite increasing age being associated with increased postablation VNS scores, age and the advanced Australian technique were found to confer greater patient self-reported treatment benefit.


CONCLUSIONS
The advanced Australian technique provides a significant benefit over the early Australian technique for the treatment of lumbar facet pain, both in magnitude and duration of pain relief.
Department of Anesthesiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Jeffrey T
JT
Loh
Department of Anesthesiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Andrea L
AL
Nicol
Department of Biomathematics, University of California Los Angeles, Los Angeles, CA, USA.
David
D
Elashoff
Department of Anesthesiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
F Michael
FM
Ferrante
interventional pain management; low-back pain; lumbar facet arthropathy; radiofrequency ablation