Medial Branch Radiofrequency Ablation as an Alternative of Vertebroplasty for Pain Treatment after Vertebral Compression Fractures

Abstract

Vertebral fractures are very frequent among the population affected by osteoporosis, being pain one of the most distressing associated symptoms. The classic treatment of vertebral fractures is, in principle, conservative. However, in the case of persistent pain, vertebral augmentation techniques and radiofrequency ablation (in the event that vertebral augmentation techniques can’t be applied) have proved to be useful. We present the case of a patient who developed severe pain secondary to an acute T2 and L3 fracture, in addition to a posterior T6 fracture. It was treated successfully with L3 vertebroplasty and facet joints denervation of T1-T2 and later T5-T6, this being justified by the technical impossibility of performing vertebroplasty on said levels. The patient was discharged from the hospital with managed pain relief and more than a 50% reduction in opioids doses. Three months later, she continued experiencing pain relief. Radiofrequency ablation of the medial branch of facet joints can be useful in the treatment of pain associated with vertebral fractures in patients where vertebral augmentation techniques are contraindicated or as a complementary treatment for persistent pain. Key words: Vertebral compression fracture, percutaneous vertebroplasty, radiofrequency ablation, medial branch, facet joints, osteoporosis