Factors Predicting Success and Failure for Cervical Facet Radiofrequency Denervation

Cohen, Steven P.; Bajwa, Zahid H.; Kraemer, Jan J.; Dragovich, Anthony; Williams, Kayode; Stream, Joshua; Sireci, Anthony; McKnight, Giselle; Hurley, Robert W.

doi:10.1097/00115550-200711000-00007

Cited by 14 publications

(5 citation statements)

References 43 publications

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“…Similar to several studies evaluating surgical or non-surgical interventions, the authors found that opioid use was correlated with treatment failure in multivariate analysis [ 26 , 29 , 30 ]. This phenomenon can be explained by opioid-induced hyperalgesia, lower pain threshold, or exaggerated expectations in the patients.…”

Section: Discussionsupporting

confidence: 62%

Predictive factors associated with successful response to utrasound guided genicular radiofrequency ablation

Köse

Çelikel³

et al. 2022

Korean J Pain

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Background: Ultrasound-guided genicular nerve radiofrequency (RF) procedures are of interest in the management of chronic knee pain. A wide variety of demographic, clinical, and procedural characteristics can affect treatment success. This study aimed to determine predictive factors to provide superior treatment outcomes. Methods: The demographic, clinical, and technical data of patients who received genicular nerve RF for knee pain between September 2016 and September 2021 were evaluated. A positive outcome was defined as at least 50% pain relief on a pain score for at least 6 months. Logistic regression analysis was performed to determine the factors associated with a successful response to genicular RF. Results: Among 206 patients who underwent genicular RF, 62% of the patients reported successful outcomes at 6 months. In the multivariate model, targeting 5 nerves (odds ratio [OR], 6.184; 95% confidence interval [CI], 2.291-16.690; P < 0.001) was the most significant predictor of successful outcomes. Multivariable logistic regression analysis showed that prognostic genicular nerve block with a 50% cut-off value (OR, 2.109; 95% CI, 1.038-4.287; P = 0.039), no opioid use (OR, 2.753; 95% CI, 1.405-5.393; P = 0.003), and depression (OR, 0.297; 95% CI, 0.124-0.713; P = 0.007) were the predictive factors significantly associated with response to genicular RF. Conclusions: Clinical and technical factors associated with better treatment outcomes were ultimately targeting more nerves, performing prognostic block, no opioid use, and no depression. These results are expected to be considered when selecting patients for genicular RF.

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Section: Discussionsupporting

confidence: 62%

Predictive factors associated with successful response to utrasound guided genicular radiofrequency ablation

Köse

Çelikel³

et al. 2022

Korean J Pain

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“…In the only study comparing the treatment results between cutoff thresholds of 50 and 80% for SIJ pain, no difference was found between RF denervation outcomes [36]. Similarly, no differences for cervical and lumbar facet RF denervation outcomes have been noted when 50 and 80% cutoff thresholds were compared [91,98]. The results for RF denervation are consistent with other treatments that have found no differences in outcomes between using 50% thresholds for screening procedures and more stringent reference standards (Table 6) [99,100].…”

Section: Patient Selectionmentioning

confidence: 99%

Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment

Cohen

Chen

Neufeld

2013

Expert Review of Neurotherapeutics

336

236

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Sacroiliac joint (SIJ) pain is an underappreciated source of mechanical low back pain, affecting between 15 and 30% of individuals with chronic, nonradicular pain. Predisposing factors for SIJ pain include true and apparent leg length discrepancy, older age, inflammatory arthritis, previous spine surgery, pregnancy and trauma. Compared with facet-mediated and discogenic low back pain, individuals with SIJ pain are more likely to report a specific inciting event, and experience unilateral pain below L5. Owing in part to its size and heterogeneity, the pain referral patterns of the SIJ are extremely variable. Although no single physical examination or historical feature can reliably identify a painful SIJ, studies suggest that a battery of three or more provocation tests can predict response to diagnostic blocks. Evidence supports both intra- and extra-articular causes for SIJ pain, with clinical studies demonstrating intermediate-term benefit for both intra- and extra-articular steroid injections. In those who fail to experience sustained relief from SIJ injections, radiofrequency denervation may provide significant relief lasting up to 1 year. This review covers all aspects of SIJ pain, with the treatment section being primarily focused on procedural interventions.

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“…Fourth, patients with previous spine surgery were enrolled in the study, which might have affected the outcome. However, a recent study showed no difference in success rates between previous surgical and nonsurgical patients (15,37). Fifth, oral medication and physiotherapy before and after intervention were not demonstrated, which might have affected the result.…”

Section: Limitationsmentioning

confidence: 95%

Combined Continuous Radiofrequency Ablation and Pulsed Neuromodulation to Treat Cervical Facet Joint Pain and Alleviate Postcervical Radiofrequency Side Effects

Malaithong¹,

Munjupong²

2022

Anesth Pain Med

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Background: Continuous radiofrequency ablation (RFA) can effectively manage cervical facet joint pain related to neuropathic symptoms in the post-radiofrequency period. Additionally, pulse radiofrequency (PRF) provides relief of neuropathic symptoms. However, the effect of combined RFA and PRF has yet to be determined. Objectives: The study aimed to compare the effectiveness and safety of RFA (CRF group) and combined RFA and PRF (CPRF group). Methods: The study retrospectively reviewed the charts of patients with cervical facet joint pain undergoing RFA between June 1, 2014, and June 1, 2017, or combined RFA and PRF between June 1, 2017, and June 1, 2020, at a pain research center. Thirty-nine consecutive patients identified from charts meeting the inclusion criteria were included and classified in CRF (n = 22) and CPRF groups (n = 17). The results were evaluated using a Visual Analog Scale (VAS) and neck pain disability index (NDI) before procedures and 1, 3, and 6 months after the injections. Successful treatment was expressed as at least 80% pain relief from baseline and NDI score 0.05). The median time to the reoccurrence of at least 50% of preprocedural pain level was 303.8 days in the CRF group and 270 days in the CPRF group (P = 0.395). However, the CPRF group showed significantly less postoperative numbness, dysesthesia, and hypersensitivity syndrome than the CRF group (P < 0.05). Conclusions: Combined RFA and PRF can be complementary treatment for cervical facet joint pain, providing an adequate success rate and duration of pain relief as RFA alone but with significantly fewer post-radiofrequency side effects.

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Factors Predicting Success and Failure for Cervical Facet Radiofrequency Denervation

Cited by 14 publications

References 43 publications

Predictive factors associated with successful response to utrasound guided genicular radiofrequency ablation

Predictive factors associated with successful response to utrasound guided genicular radiofrequency ablation

Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment

Combined Continuous Radiofrequency Ablation and Pulsed Neuromodulation to Treat Cervical Facet Joint Pain and Alleviate Postcervical Radiofrequency Side Effects

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