Factors Predicting Success and Failure for Cervical Facet Radiofrequency Denervation: A Multi-Center Analysis

Abstract

Selecting patients based on key clinical variables may increase the chance of treatment success for cervical facet radiofrequency denervation.

Abordaje intervencionista del síndrome facetario lumbar: Denervación con radiofrecuencia

“…Algunos predictores de mala respuesta son la depresión, el síndrome de cirugía fallida y la afectación de múltiples niveles; debiendo tener estos factores en cuenta a la hora de indicar el procedimiento 14,[38][39][40][41][42] .…”

Radiofrequency therapy in back pain and complex regional pain syndrome

“…[43][44][45][46] Some clinical features used as a screening instrument, may increase the probability that facet arthropathy is present. 47,48 However, the only validated method to reliably diagnose facet joint pain is a clinically controlled protocol of local anesthetic blocks of the supplying medial branches. 38,49 Under fluoroscopic guidance and aided by X-ray contrast, in order to prevent aberrant spread of the local anesthetic or venous uptake, 50 the medial branches of the suspected joints are anesthetized on two different occasions, once with a long and once with a short-acting local anesthetic.…”

“…52 Yet, the research concerning this debate suggests that there is no difference in the outcome of the radiofrequency neurotomy if 50% or 80% of pain relief is used as a cut-off value. 47,54 Too stringent selection criteria, in addition to the considerable false negative rate of diagnostic blocks, may even exclude suitable patients from a potentially effective treatment. 52,54,57 Single blocks are not sufficient due to their high false-positive rates.…”

Whiplash associated disorders: A prospective investigation of the effects of cervical medial branch radiofrequency neurotomy on sensory, motor and psychological Features

“…Other physical examination methods have been evaluated in a study attempting to predict success of RFN (based on a prior successful response to a single diagnostic medial branch block) [303]. Paraspinal tenderness in the neck region was predictive of successful outcome of RFN but 'facet loading', combining active rotation and/or extension movement was not predictive of success with RFN.…”

“…Paraspinal tenderness in the neck region was predictive of successful outcome of RFN but 'facet loading', combining active rotation and/or extension movement was not predictive of success with RFN. Success was defined as greater than 50% pain relief six months after the procedure was performed [303].…”