Use of Lumbar Motion Monitor to Predict Response to Radiofrequency Ablation After Medial Branch Diagnostic Blocks

2019 ◽  
Author(s):  
Keyword(s):  
Radiofrequency Ablation ◽  
Medial Branch ◽  
Lumbar Motion

scholarly journals Bilateral Intra-Articular Radiofrequency Ablation for Cervicogenic Headache

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Charles A. Odonkor ◽  
Teresa Tang ◽  
David Taftian ◽  
Akhil Chhatre
Keyword(s):  
Radiofrequency Ablation ◽  
Pain Relief ◽  
Symptomatic Relief ◽  
Cervicogenic Headache ◽  
Term Treatment ◽  
Medial Branch ◽  
Neck Stiffness ◽  
Intervertebral Disks ◽  
Long Term Treatment ◽  
Improved Function

Introduction. Cervicogenic headache is characterized by unilateral neck or face pain referred from various structures such as the cervical joints and intervertebral disks. A recent study of patients with cervical pain showed significant pain relief after cervical medial branch neurotomy but excluded patients with C1-2 joint pain. It remains unclear whether targeting this joint has potential for symptomatic relief. To address this issue, we present a case report of C1-2 joint ablation with positive outcomes. Case Presentation. A 27-year-old female presented with worsening cervicogenic headache. Her pain was 9/10 by visual analog scale (VAS) and described as cramping and aching. Pain was localized suboccipitally with radiation to her jaw and posterior neck, worse on the right. Associated symptoms included clicking of her temporomandibular joint, neck stiffness, bilateral headaches with periorbital pain, numbness, and tingling. History, physical exam, and diagnostic studies indicated localization to the C1-2 joint with 80% decrease in pain after C1-2 diagnostic blocks. She underwent bilateral intra-articular radiofrequency ablation of the C1-C2 joint. Follow-up at 2, 4, 8, and 12 weeks showed improved function and pain relief with peak results at 12 weeks. Conclusion. Clinicians may consider C1-C2 joint ablation as a viable long-term treatment option for cervicogenic headaches.

What is the Effect of Lumbar Medial Branch Nerve Radiofrequency Ablation on Lumbar Spondylolisthesis: A Single-Center, Observational Study

2021 ◽  
Author(s):  
Trusharth Patel ◽  
Christopher Watterson ◽  
Anne Marie McKenzie-Brown ◽  
Boris Spektor ◽  
Katherine Egan ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Degenerative Spondylolisthesis ◽  
Lumbar Pain ◽  
Spinal Instability ◽  
Medial Branch ◽  
Single Center ◽  
Spine Imaging ◽  
Grade Ii ◽  
Lumbar Spondylolisthesis

Abstract Background Radiofrequency ablation (RFA) is a denervation therapy commonly performed for pain of facet etiology. Degenerative spondylolisthesis, a malalignment of the spinal vertebrae, may be a co-existing condition contributing to pain; yet the effect of RFA on advancing listhesis is unknown. To the extent that denervating RFA can weaken paraspinal muscles that provide stability to the spine, the therapy can potentially contribute to progressive spinal instability. Objectives To test the hypothesis that RFA of painful facets in the setting of spondylolisthesis may contribute to advancement of further degenerative spondylolisthesis. Methods Single-center, prospective, observational pilot study in an interventional pain practice. Fifteen participants with pre-existing degenerative Grade I or Grade II spondylolisthesis and coexisting axial lumbar pain underwent lumbar RFA encompassing spondylolisthesis level and followed with post-RFA imaging at 12 months and beyond to measure percent change in spondylolisthesis. Results The primary outcome was the percent advancement of spondylolisthesis per year measured on post-RFA lateral lumbar spine imaging compared to non-intervention baseline advancement of 2.6% per limited observational studies. Among the 15 participants enrolled, 14 completed the study (median age 66; 64.3% women; median BMI 33.5; mean follow-up time 23.9 months). The mean advancement of spondylolisthesis per year after RFA was 1.30% (95% CI -0.14 to 2.78%), with 9/14 below 1.25%. Conclusion Among patients with lumbar pain originating from facets in the setting of degenerative spondylolisthesis who underwent lumbar RFA, the observed advancement of spondylolisthesis is clinically similar to the baseline of 2.6% per year change. The study findings did not find a destabilizing effect of lumbar RFA in advancing spondylolisthesis in this patient population.

scholarly journals Randomized prospective trial of cooled versus traditional radiofrequency ablation of the medial branch nerves for the treatment of lumbar facet joint pain

2019 ◽  
Vol 44 (3) ◽  
pp. 389-397 ◽  
Author(s):  
Zachary L McCormick ◽  
Heejung Choi ◽  
Rajiv Reddy ◽  
Raafay H Syed ◽  
Meghan Bhave ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Success Rate ◽  
Joint Pain ◽  
Rating Scale ◽  
Facet Joint ◽  
Prospective Trial ◽  
Medial Branch ◽  
Lumbar Facet Joint ◽  
Facet Joint Pain ◽  
Lumbar Facet

Background and objectivesNo previous study has assessed the outcomes of cooled radiofrequency ablation (C-RFA) of the medial branch nerves (MBN) for the treatment of lumbar facet joint pain nor compared its effectiveness with traditional RFA (T-RFA). This study evaluated 6-month outcomes for pain, function, psychometrics, and medication usage in patients who underwent MBN C-RFA versus T-RFA for lumbar Z-joint pain.MethodsIn this blinded, prospective trial, patients with positive diagnostic MBN blocks (>75% relief) were randomized to MBN C-RFA or T-RFA. The primary outcome was the proportion of ‘responders’ (≥50% Numeric Rating Scale (NRS) reduction) at 6 months. Secondary outcomes included NRS, Oswestry Disability Index (ODI), and Patient Global Impression of Change.ResultsForty-three participants were randomized to MBN C-RFA (n=21) or T-RFA (n=22). There were no significant differences in demographic variables (p>0.05). A ≥50% NRS reduction was observed in 52% (95% CI 31% to 74%) and 44% (95% CI 22% to 69%) of participants in the C-RFA and T-RFA groups, respectively (p=0.75). A ≥15-point or ≥30% reduction in ODI score was observed in 62% (95% CI 38% to 82%) and 44% (95% CI 22% to 69%) of participants in the C-RFA and T-RFA groups, respectively (p=0.21).ConclusionsWhen using a single diagnostic block paradigm with a threshold of >75% pain reduction, both treatment with both C-RFA and T-RFA resulted in a success rate of approximately 50% when defined by both improvement in pain and physical function at 6-month follow-up. While the success rate was higher in the C-RFA group, this difference was not statistically significant.Trial registration numberNCT02478437.

scholarly journals Predicting Treatment Success with Facet Syndrome: An Algorithm to Predict Lumbar Radiofrequency Ablation Responders in a Military Population

Pain Medicine ◽  
2020 ◽  
Author(s):  
Scott Hughey ◽  
Jacob Cole ◽  
Gregory Booth ◽  
Jeffrey Moore ◽  
Benjamin McDowell ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Functional Status ◽  
Scoring System ◽  
Smoking History ◽  
Secondary Outcome ◽  
Medial Branch ◽  
Pain Scores ◽  
C Statistic ◽  
Medial Branch Block ◽  
Facet Syndrome

Abstract Objective Radiofrequency ablation (RFA) of the medial branch nerve is a commonly performed procedure for patients with facet syndrome. RFA has previously been demonstrated to provide long-term functional improvement in approximately 50% of patients, including those who had significant pain relief after diagnostic medial branch block. We sought to identify factors associated with success of RFA for facet pain. Design Active-duty military patients who underwent lumbar RFA (L3, L4, and L5 levels) over a 3-year period were analyzed. Defense and Veterans Pain Rating Scale (DVPRS) and Oswestry Disability Index (ODI) scores were assessed the day of procedure and at the 2-month and 6-month follow-up. These data were analyzed to identify associations between patient demographics, pain, and functional status and patients’ improvement after RFA, with a primary outcome of ODI improvement and a secondary outcome of pain reduction. Results Higher levels of starting functional impairment (starting ODI scores of 42.9 vs. 37.5; P = 0.0304) were associated with a greater likelihood of improvement in functional status 6 months after RFA, and higher starting pain scores (DVPRS pain scores of 6.1 vs. 5.1; P < 0.0001) were associated with a higher likelihood that pain scores would improve 6 months after RFA. A multivariate logistic regression was then used to develop a scoring system to predict improvement after RFA. The scoring system generated a C-statistic of 0.764, with starting ODI, pain scores, and both gender and smoking history as independent variables. Conclusions This algorithm compares favorably to that of diagnostic medial branch block in terms of prediction accuracy (C-statistic of 0.764 vs. 0.57), suggesting that its use may improve patient selection in patients who undergo RFA for facet syndrome.

Technique for CT Fluoroscopy–Guided Lumbar Medial Branch Blocks and Radiofrequency Ablation

2016 ◽  
Vol 207 (3) ◽  
pp. 631-634 ◽  
Author(s):  
Timothy J. Amrhein ◽  
Anand B. Joshi ◽  
Peter G. Kranz
Keyword(s):  
Radiofrequency Ablation ◽  
Medial Branch ◽  
Ct Fluoroscopy

scholarly journals Effect of Lumbar Medial Branch Nerve Radiofrequency Ablation on Lumbar Spondylolisthesis

2020 ◽  
Author(s):  
Trusharth Patel ◽  
Christopher Watterson ◽  
Anne Marie McKenzie-Brown ◽  
Boris Spektor ◽  
Katherine Egan ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Degenerative Spondylolisthesis ◽  
Lumbar Pain ◽  
Medial Branch ◽  
Academic Center ◽  
Spine Imaging ◽  
Grade Ii ◽  
The Mean ◽  
Lumbar Spondylolisthesis

AbstractImportanceRadiofrequency ablation (RFA) is a denervation therapy commonly performed for pain of facet etiology. Degenerative spondylolisthesis may be a co-existing condition; yet the effect of RFA on advancing listhesis is unknown.ObjectiveTo test the hypothesis that RFA of painful facets in the setting of spondylolisthesis may contribute to advancement of further degenerative spondylolisthesis.DesignRetrospective and prospective, observational study conducted at a single academic center among 15 participants with pre-existing degenerative Grade I or Grade II spondylolisthesis undergoing lumbar RFA encompassing spondylolisthesis level and followed with post-RFA imaging at 12 months and beyond to measure percent change in spondylolisthesis.Main Outcomes and MeasuresThe primary outcome was the percent advancement of spondylolisthesis per year measured on post-RFA lateral lumbar spine imaging compared to non-intervention baseline advancement of 2.6% per limited observational studies.ResultsAmong the 15 participants enrolled, 14 completed the study (median age 66; 64.3% women; median BMI 33.5; mean follow-up time 23.9 months). The mean advancement of spondylolisthesis per year after RFA was 1.30% (95% CI −0.14 to 2.78%), with 9/14 below 1.25%.Conclusion and RelevanceAmong patients with lumbar pain originating from facets in the setting of degenerative spondylolisthesis who underwent lumbar RFA, the observed advancement of spondylolisthesis is clinically similar to the baseline of 2.6% per year change. The study findings did not find a destabilizing effect of lumbar RFA in advancing spondylolisthesis in this patient population.

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