The Efficacy of Radiofrequency Ablation for Pain Management in Patients with Pre-Existing Hardware at the Site of Ablation

Abstract

Introduction: Radiofrequency ablation (RFA) is an interventional procedure that provides pain relief by using thermal energy to disrupt peripheral nerves carrying nociceptive signals back to the central nervous system. In the past, having implantable hardware at the planned site of RFA was considered to confer increased risk of adverse outcomes given the theoretical risk of heating of the hardware components. The present study examines patient outcomes to determine whether the efficacy of RFA was affected by the presence of implanted hardware directly at the site. Methods: This was a retrospective case-control study that included 52 patients who received RFA procedures in the presence of hardware at the site of RFA and a control group of 170 patients who received RFA procedures in the absence of hardware. Data were collected from electronic medical records entered into an Excel sheet and then analyzed using SPSS version 22. Outcomes tested included post procedure pain scores, percent, and duration of improvement, if any. Results: We found no statistically significant difference in measured outcomes between either group. Conclusions: This study provides some evidence in support of the theory that RFA procedures performed on patients with pre-existing hardware have similar efficacy when compared to their hardware-free counterparts.

Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review

“…After diagnosing the specific level of the spine responsible for the pain, a physician may choose to perform RFA of the nerve. RFA procedures on patients with preexisting hardware have similar efficacy to those performed on individuals without hardware [ 76 ]. In patients with an optimal response to diagnostic nerve blocks, RFA significantly reduces facet joint pain during the first 12 months after the procedure [ 77 ].…”