Facet median branch radiofrequency thermocoagulation treatment at different temperatures and durations in patients with lumbar facet syndrome: a randomized controlled, double-blind study

Ertilav, Esra; Aydın, Osman Nuri; Erel, K Varlik

doi:10.5137/1019-5149.jtn.34637-21.2

Cited by 6 publications

(11 citation statements)

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“…The effect of temperature and duration of lesioning were studied in 96 patients with lumbar facet joint pain using a single block. No difference was found in categorical outcomes at 1 and 6‐month follow‐ups between lesioning at 90°C for 50 s, 85°C for 60 s, or 70°C for 90 s 84 . However, this study was underpowered and experimental studies have found larger lesions when higher temperatures and longer heating times are employed, as recommended in the lumbar facet guidelines 5,126 …”

Section: Techniquesmentioning

confidence: 81%

Section: Treatment Optionsmentioning

confidence: 88%

“…Consistent with the biopsychosocial model of pain, studies have shown that some psychological, social factors and biological factors (previous surgery, radicular signs, predominantly midline pain) have a greater risk for poorer radiofrequency outcomes. [82][83][84] Studies have found depression, substance misuse, younger age, a greater Cobb angle and more non-organic (Waddell) signs to be associated with negative lumbar facet radiofrequency outcomes. 82 In one study evaluating outcomes in 101 Worker's compensation cases, retaining an attorney was associated with a >7-fold increased risk of posttreatment physical disability, along with greater bodily pain, functional impairment, and less vitality.…”

Section: Biopsychosocial Factors Influencing Outcome Of Radiofrequencymentioning

confidence: 99%

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3. Pain originating from the lumbar facet joints

Van den Heuvel,

Cohen,

de Andrès Ares

et al. 2023

Pain Practice

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IntroductionPain originating from the lumbar facets can be defined as pain that arises from the innervated structures comprising the joint: the subchondral bone, synovium, synovial folds, and joint capsule. Reported prevalence rates range from 4.8% to over 50% among patients with mechanical low back pain, with diagnosis heavily dependent on the criteria employed. In well‐designed studies, the prevalence is generally between 10% and 20%, increasing with age.MethodsThe literature on the diagnosis and treatment of lumbar facet joint pain was retrieved and summarized.ResultsThere are no pathognomic signs or symptoms of pain originating from the lumbar facet joints. The most common reported symptom is uni‐ or bilateral (in more advanced cases) axial low back pain, which often radiates into the upper legs in a non‐dermatomal distribution. Most patients report an aching type of pain exacerbated by activity, sometimes with morning stiffness. The diagnostic value of abnormal radiologic findings is poor owing to the low specificity. SPECT can accurately identify joint inflammation and has a predictive value for diagnostic lumbar facet injections. After “red flags” are ruled out, conservatives should be considered. In those unresponsive to conservative therapy with symptoms and physical examination suggesting lumbar facet joint pain, a diagnostic/prognostic medial branch block can be performed which remains the most reliable way to select patients for radiofrequency ablation.ConclusionsWell‐selected individuals with chronic low back originating from the facet joints may benefit from lumbar medial branch radiofrequency ablation.

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Section: Techniquesmentioning

confidence: 81%

Section: Treatment Optionsmentioning

confidence: 88%

Section: Biopsychosocial Factors Influencing Outcome Of Radiofrequencymentioning

confidence: 99%

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3. Pain originating from the lumbar facet joints

Van den Heuvel,

Cohen,

de Andrès Ares

et al. 2023

Pain Practice

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“…All selected studies were double-blind randomized clinical trials and observational studies, totaling 972 patients. Table 1 10 11 12 13 14 15 16 17 18 19 20 21 summarizes the main features of each study, highlighting the author, year of publication, number of patients, their age and distribution, and the main conclusions.…”

Section: Resultsmentioning

confidence: 99%

“…11 The use of different temperatures for RF neuroablation was effective even in 49 patients with pain due to a secondary etiology. 12 Outcomes regarding the effectiveness of neuroablation were equally effective in terms of different temperatures and time variables from each group. RF at 90 °C yielded better outcomes compared with a temperature of 80 °C.…”

Section: Discussionmentioning

confidence: 97%

Síndrome facetária lombar e a utilização da técnica de ablação por radiofrequência como terapia alternativa: uma revisão sistemática

Bernardes

Corrêa

Trajano

et al. 2023

Rev Bras Ortop (Sao Paulo)

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ResumoEm um contexto de aumento da prevalência de queixas de dores na coluna, a síndrome facetária se destaca como um importante causador. Alternativas como a ablação por radiofrequência (RF) podem ser uma opção de terapia para alívio da dor crônica que essa patologia pode causar. É necessário analisar a eficácia do tratamento da síndrome facetária pela técnica de ablação por radiofrequência tradicional e o alívio gerado nas dores lombares crônicas (DLC). O presente estudo trata-se de uma revisão sistemática cujo os critérios de inclusão para análise foram: título; estudos observacionais; ensaios clínicos; ensaio clínico controlado; estudos clínicos e publicação nos últimos dezessete anos (2005–2022). Já os critérios de exclusão foram: artigos que abordavam outras temáticas e artigos de revisão. As bases utilizadas para coleta de dados incluíram Medical Literature Analysis and Retrieval System online (Medline), Pubmed, Scientific Electronic Library Online (SciELO), Lilacs, Biblioteca Virtual em Saúde. Os termos utilizados para a pesquisa foram: facet; pain; lumbar; radiofrequency. Aplicando-se os filtros foram encontrados 142 estudos, 12 foram incluídos. Os estudos em sua maioria apontaram ser benéfica a técnica de ablação por radiofrequência tradicional no alívio das dores lombares crônicas refratárias ao tratamento conservador.

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Radiofrequency Denervation of the Spine and the Sacroiliac Joint: A Systematic Review based on the Grades of Recommendations, Assesment, Development, and Evaluation Approach Resulting in a German National Guideline

Klessinger,

Casser,

Gillner

et al. 2024

Global Spine Journal

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Study Design Systematic review of the literature and subsequent meta-analysis for the development of a new guideline. Objectives This manuscript summarizes the recommendations from a new clinical guideline published by the German Spine Society. It covers the current evidence on recommendations regarding the indication, test blocks and use of radiofrequency denervation. The guidelines aim is to improve patient care and efficiency of the procedure. Methods A multidisciplinary working group formulated recommendations based on the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) approach and the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Results 20 clinical questions were defined for guideline development, with 87.5% consensus achieved by committee members for one recommendation and 100% consensus for all other topics. Specific questions that were addressed included clinical history, examination and imaging, conservative treatment before injections, diagnostic blocks, the injected medications, the cut-off value in pain-reduction for a diagnostic block as well as the number of blocks, image guidance, the cannula trajectories, the lesion size, stimulation, repeat radiofrequency denervation, sedation, cessation or continuation of anticoagulants, the influence of metal hardware, and ways to mitigate complications. Conclusion Radiofrequency (RF) denervation of the spine and the SI joint may provide benefit to well-selected individuals. The recommendations of this guideline are based on very low to moderate quality of evidence as well as professional consensus. The guideline working groups recommend that research efforts in relation to all aspects of management of facet joint pain and SI joint pain should be intensified.

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Facet median branch radiofrequency thermocoagulation treatment at different temperatures and durations in patients with lumbar facet syndrome: a randomized controlled, double-blind study

Cited by 6 publications

References 0 publications

3. Pain originating from the lumbar facet joints

3. Pain originating from the lumbar facet joints

Síndrome facetária lombar e a utilização da técnica de ablação por radiofrequência como terapia alternativa: uma revisão sistemática

Radiofrequency Denervation of the Spine and the Sacroiliac Joint: A Systematic Review based on the Grades of Recommendations, Assesment, Development, and Evaluation Approach Resulting in a German National Guideline

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