Anas Afifi1, Mathis Ringe1, Rolf Sobottke1,2, Stavros Oikonomidis2. 1. Department of Spine and Neurosurgery, Rheinmaasklinikum, Würselen, Germany. 2. Department of Orthopedics and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Abstract
BACKGROUND: It was hypothesized that radiofrequency denervation (RFD) of lumbar facet joints is associated with superior pain abolishment and less complications than chemical neurolysis (with ethyl alcohol or glycerol) in patients with chronic facet joint arthropathy. METHODS: For this prospective cohort study, adult patients with chronic lumbar facet joint arthropathy were prospectively enrolled between 2017 and 2019. The following groups were compared before the intervention and 6 weeks, 6 months, and 12 months after the intervention: RFD, chemical neurolysis with ethyl alcohol 95% (EA-95), or glycerol 20% (Gly-20). Outcome parameters included the Core Outcome Measures Index for the back (COMI-back), World Health Organization (WHO) pain ladder level, and visual analog scale (VAS). P values <0.05 were considered statistically significant. RESULTS: A total of 95 patients with a mean age of 63.7 years were included. Among them, 30 patients underwent RFD, 30 patients were treated with EA-95, and 35 individuals were treated with Gly-20. After 6 weeks, RFD patients had significantly lower VAS scores compared with the EA-95 group. After 6 months, both VAS and COMI were significantly lower in RFD patients than in the Gly-20 group. Twelve months after intervention, VAS scores were significantly lower in the RFD group compared with the Gly-20 group. CONCLUSIONS: This study reveals that RFD is associated with improved pain relief and quality of life compared with chemical neurolysis for facet joint-related chronic lower back pain and should be considered as the treatment of choice in patients with chronic low back pain due to facet joint arthropathy. CLINICAL RELEVANCE: The current study provides information that may improve clinical decision making in the treatment of chronic lumbar facet joint arthropathy and to appropriately counsel such patients about expected outcomes. This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery.
BACKGROUND: It was hypothesized that radiofrequency denervation (RFD) of lumbar facet joints is associated with superior pain abolishment and less complications than chemical neurolysis (with ethyl alcohol or glycerol) in patients with chronic facet joint arthropathy. METHODS: For this prospective cohort study, adult patients with chronic lumbar facet joint arthropathy were prospectively enrolled between 2017 and 2019. The following groups were compared before the intervention and 6 weeks, 6 months, and 12 months after the intervention: RFD, chemical neurolysis with ethyl alcohol 95% (EA-95), or glycerol 20% (Gly-20). Outcome parameters included the Core Outcome Measures Index for the back (COMI-back), World Health Organization (WHO) pain ladder level, and visual analog scale (VAS). P values <0.05 were considered statistically significant. RESULTS: A total of 95 patients with a mean age of 63.7 years were included. Among them, 30 patients underwent RFD, 30 patients were treated with EA-95, and 35 individuals were treated with Gly-20. After 6 weeks, RFD patients had significantly lower VAS scores compared with the EA-95 group. After 6 months, both VAS and COMI were significantly lower in RFD patients than in the Gly-20 group. Twelve months after intervention, VAS scores were significantly lower in the RFD group compared with the Gly-20 group. CONCLUSIONS: This study reveals that RFD is associated with improved pain relief and quality of life compared with chemical neurolysis for facet joint-related chronic lower back pain and should be considered as the treatment of choice in patients with chronic low back pain due to facet joint arthropathy. CLINICAL RELEVANCE: The current study provides information that may improve clinical decision making in the treatment of chronic lumbar facet joint arthropathy and to appropriately counsel such patients about expected outcomes. This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery.
Authors: Mark V Boswell; Andrea M Trescot; Sukdeb Datta; David M Schultz; Hans C Hansen; Salahadin Abdi; Nalini Sehgal; Rinoo V Shah; Vijay Singh; Ramsin M Benyamin; Vikram B Patel; Ricardo M Buenaventura; James D Colson; Harold J Cordner; Richard S Epter; Joseph F Jasper; Elmer E Dunbar; Sairam L Atluri; Richard C Bowman; Timothy R Deer; John R Swicegood; Peter S Staats; Howard S Smith; Allen W Burton; David S Kloth; James Giordano; Laxmaiah Manchikanti Journal: Pain Physician Date: 2007-01 Impact factor: 4.965
Authors: A F Mannion; A Vila-Casademunt; M Domingo-Sàbat; S Wunderlin; F Pellisé; J Bago; E Acaroglu; A Alanay; F S Pérez-Grueso; I Obeid; F S Kleinstück Journal: Eur Spine J Date: 2015-10-30 Impact factor: 3.134