Pulsed Radiofrequency for Lumbar Facet Joint Pain: A Viable Therapeutic Option? A Retrospective Observational Study

Abstract

Introduction: Low back pain (LBP) is a common problem, and facet joint pain is responsible for 15-45% of cases. Treatment is multidisciplinary, and when conservative measures are not sufficient, radiofrequency (RF) is often used. It allows the interruption of nociceptive input, producing a heat lesion in a continuous or pulsed mode. Methods: Medical records of 60 patients who underwent pulsed RF denervation were examined. The standard procedure provided followup of pain intensity. Numerical rating scale (NRS) and Douleur Neuropathique en 4 Questions (DN4) were recorded before treatment, and 15 and 40 days, and 6 months after treatment. Oswestry Disability Index (ODI) and patient satisfaction were also recorded. Successful treatment was defined as more than a 50% reduction in the NRS scores at 6 months compared with pretreatment scores. Results: Scores on the NRS and DN4 were statistically different over time (p \ 0.05). Scores at 6 months were significantly decreased when compared with pretreatment scores (p \ 0.05). ODI scores decreased during the follow-up period. No adverse effect was recorded and 57 patients (97%) reported successful pain relief. Conclusions: Continuous RF is the gold standard in the management of lumbar facet joint pain. Pulsed RF is a promising technique: patients with chronic LBP who had not responded to conservative care tended to improve after pulsed RF. The procedure was well tolerated in the absence of contraindications, and reliable if the nerve endings regrew.

Clinical Outcome of Pulsed-Radiofrequency Combined With Transforaminal Epidural Steroid Injection for Lumbosacral Radicular Pain Caused by Distinct Etiology

“…Similarly, previous data has demonstrated that PRF combined with TESI achieved better clinical outcome of lumbar DH than PRF alone 1 month after procedure ( Ding et al, 2018 ). Despite relief from pain, PRF can achieve significant functional improvement, demonstrated by the reduction of Oswestry Disability Index scores ( Sansone et al, 2020 ). One significant limitation of this study was that we did not perform functional evaluation pre- and post-treatment systematically.…”

Effects of Pulse Radiofrequency Application on Health-Related Quality of Life in Patients with Lumbar Facet Syndrome

“…Bu iletinin kesilmesini hedef alan tedavi yöntemleri faset ağrısında başarılı olmaktadır. Medial dal blokları ve medial dal sinirlerinin radyofrekans denervasyonu gibi faset eklem müdahaleleri klinik uygulamalarda yaygın olarak kullanılır (18,19). Literatürde LFS hastalarında PRF yönteminin başarılı olduğu ile ilgili çalışmalar bulunmaktadır.…”

Effect of radiofrequency denervation on pain severity among patients with cervical, thoracic or lumbar spinal pain: A clinical retrospective study

“…In the literature, patients who respond well to the RFA procedure are those who have high preoperative VAS scores and use low-dose NSAIDs [ 7 , 33 , 34 ]. However, in our study, no pre-procedure demographic data (including NSAID use) were related to the clinical relief seen in the postoperative period.…”