Safety of Lumbar Spine Radiofrequency Procedures in Patients Who Have Posterior Spinal Hardware

Lamer, Tim J.; Smith, Jolene M.; Hoelzer, Bryan C.; Mauck, William D.; Qu, Wenchun; Gazelka, Halena M.

doi:10.1093/pm/pnv078

Cited by 16 publications

(22 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Following the aforementioned cadaver study, an in vivo prospective study was performed that measured intraoperative pedicle screw temperature during 10 lumbar medial branch RFNs conducted at 80°C for 90 seconds at the conventional RF cannula target position. Reported temperature changes from a preprocedure baseline to intra-procedure ranged from no change to an increase of up to 6°C (for a reported temperature of 42°C, at which point the ablation was terminated) in 2 patients (11). This increase in pedicle screw temperature appears to be incongruent with the temperature increase observed in the cadaver study.…”

Section: E481 Spinal Radiofrequency Neurotomy In Patients With Metallmentioning

confidence: 79%

“…A cadaver study showed that it is possible for pedicle screws to heat significantly when in direct contact with an RF cannula (10). Additionally, a prospective study showed pedicle screws are capable of temperature increases (11). Despite the potential for the transfer of heat energy to hardware, there have been no reported cases…”

Section: Methodsmentioning

confidence: 99%

“…Outcome measures were selected from potential serious complications/adverse events suggested in recently published papers (10,11). Chart abstraction criteria were developed by the research team based on these outcome measures (Table 1).…”

Section: E479mentioning

confidence: 99%

“…in the literature of RFN-related adverse events directly attributable to the heating of metallic instrumentation (10,11). A retrospective study evaluating the safety and efficacy of RFN procedures in the presence of lumbar posterior pedicle screws reported no adverse events or worsening pain (12).…”

mentioning

confidence: 99%

See 3 more Smart Citations

A Retrospective Review of Spinal Radiofrequency Neurotomy Procedures in Patients with Metallic Posterior Spinal Instrumentation – Is it Safe?

2018

View full text Add to dashboard Cite

Background: Recent studies have shown that medial branch radiofrequency neurotomy (RFN) procedures done at the level of a pedicle screw can increase pedicle screw temperature, and it has been speculated that pedicle screw heating may cause thermal injury. There has been a limited amount of investigation into the real-world safety profile of RFN procedures in patients with pedicle screws. Objectives: We aim to demonstrate that the occurrence of serious adverse events is rare for a medial branch RFN procedure completed at a level with metallic spinal hardware when performed according to the Spine Intervention Society practice standards. Study Design: This study involved retrospective chart reviews of every patient who received an RFN procedure for spinal facet joint pain during the 5-year time period from 2012-2016. Setting: The research took place within a single university-based interventional pain management center. Methods: The study sample included 507 patient charts. Data collection included patient demographics, RF denervation sites at a level with metallic hardware, and all serious RF-related complications that could be attributable to heated metallic hardware. The research team developed medical-chart abstraction criteria for each of the following categorized complications: a) superficial burns, b) deep burns, c) denervation of dorsal ramus, d) denervation of ventral ramus, and e) coagulation of a spinal vascular structure. Results: Of the 36 patients who met the inclusion criteria for this study, 43.6% were men and 56.4% were women. The mean age was 59.5 years old, with an age range of 25 to 87 years. There were a total of 56 ablations performed at a level with metallic spinal hardware, of which 11 were cervical, 44 were lumbar, and 1 was thoracic . There were zero documented complications found among our patient population in any of the 5 categories of serious complications. Limitations: As a retrospective chart review, this study was dependent on the availability and accuracy of medical records. Chart abstraction criteria for each outcome measure were developed by the research team without scientific testing. Conclusions: There have been no reported complications attributable to hardware temperature increases when performing medial branch RFNs at the level of a pedicle screw. For safety, it is important to use multiplanar fluoroscopic imaging techniques to ensure that the RFN cannula is not in contact with the pedicle screw. Key Words: Radiofrequency neurotomy, medial branch nerve ablation, safety, thermal injuries, metallic spinal hardware, pedicle screws, lateral mass screws, cervical facet joints, severe complications, adverse events

show abstract

Section: E481 Spinal Radiofrequency Neurotomy In Patients With Metallmentioning

confidence: 79%

Section: Methodsmentioning

confidence: 99%

Section: E479mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

A Retrospective Review of Spinal Radiofrequency Neurotomy Procedures in Patients with Metallic Posterior Spinal Instrumentation – Is it Safe?

2018

View full text Add to dashboard Cite

show abstract

“…Numerous studies have examined the safety of RFA in the setting of spinal hardware. Lamer et al conducted a prospective study involving 6 patients with spinal hardware who underwent 10 RFA procedures. Using a temperature probe, the investigators measured the changes in hardware surface temperature before and after the RFA procedures.…”

Section: Discussionmentioning

confidence: 99%

Peri‐procedural Management of Implanted Spinal Cord Stimulators in Patients Undergoing Radiofrequency Ablation: A Case Report and Manufacturer‐Specific Recommendations

et al. 2019

View full text Add to dashboard Cite

Introduction Radiofrequency ablation (RFA) and spinal cord stimulation (SCS) are 2 common modalities used in management of various pain conditions. RFA generates heat and an electromagnetic field that can theoretically interfere with the functionality and longevity of the SCS device. This is problematic for patients who need RFA and have previously undergone implantation of an SCS device. Case Description We present a case highlighting the safe use of bipolar RFA in a patient who had previously undergone implantation of a cervical SCS device. Discussion We also present device‐specific industry guidelines and recommendations for performing RFA in patients following SCS device implantation.

show abstract

Safety and Efficacy of Radiofrequency Ablation of the Medial Branch Nerves with Preexisting Spinal Hardware. A Case Series and Review of Literature

Abd‐Elsayed

Fiala

Nguyen

et al. 2019

Curr Pain Headache Rep

View full text Add to dashboard Cite

Safety of Lumbar Spine Radiofrequency Procedures in Patients Who Have Posterior Spinal Hardware

Cited by 16 publications

References 14 publications

A Retrospective Review of Spinal Radiofrequency Neurotomy Procedures in Patients with Metallic Posterior Spinal Instrumentation – Is it Safe?

A Retrospective Review of Spinal Radiofrequency Neurotomy Procedures in Patients with Metallic Posterior Spinal Instrumentation – Is it Safe?

Peri‐procedural Management of Implanted Spinal Cord Stimulators in Patients Undergoing Radiofrequency Ablation: A Case Report and Manufacturer‐Specific Recommendations

Safety and Efficacy of Radiofrequency Ablation of the Medial Branch Nerves with Preexisting Spinal Hardware. A Case Series and Review of Literature

Contact Info

Product

Resources

About