Pulsed radiofrequency application in treatment of chronic zygapophyseal joint pain

Georgi Mikeladze, Ramon Espinal, Robert Finnegan, James Routon, Dan C Martin

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Background context: Chronic zygapophyseal joint arthropathy is a cause of back and neck pain. One proposed method of treating facet joint pathology is ablation of medial branches and dorsal rami with pulsed radiofrequency (RF) waves. Purpose: Assessment of efficacy of pulsed RF application for treatment of chronic zygapophyseal joint pain. Study design/setting: Retrospective study of 114 patients at a pain management clinic. Patient Sample: A total of 114 patients with clinical signs of facet joint involvement and a favorable response to a diagnostic medial branch block using local anesthetic, including 82 females and 32 males with a mean age of 52.8±12.6 years. Mean duration of pain was 7.52±5.26 years. Twenty-seven had previous back surgery, 83 patients had low back pain and 31 had cervical pain. Pain was on the left side in 47 patients, on the right side in 45 patients, bilateral in 22. Outcome measures: Result was regarded as successful if pain reduction was more than 50% on visual analog scale and the duration of effect was more than 1.5 months. Methods: After obtaining positive stimulation, pulsed RF was applied to medial branches of dorsal rami for 120 seconds with temperature at the tip of the electrode 42 C. Results: Of 114 patients, who had positive response to diagnostic block, 46 patients did not respond favorably to pulsed RF application (pain reduction less than 50%). In 68 patients, the procedure was successful and lasted on average 3.93±1.86 months. Eighteen patients had the procedure repeated with the same duration of pain relief that was achieved initially. Previous surgery, duration of pain, sex, levels (cervical vs. lumbar) and stimulation levels did not influence outcomes. Conclusion: The results of our study showed that the application of pulsed RF to medial branches of the dorsal rami in patients with chronic facet joint arthropathy provided temporary pain relief in 68 of 118 patients.

Original languageEnglish (US)
Pages (from-to)360-362
Number of pages3
JournalSpine Journal
Volume3
Issue number5
DOIs
StatePublished - Sep 1 2003

Fingerprint

Zygapophyseal Joint
Arthralgia
Pain
Therapeutics
Neck Pain
Joint Diseases
Pulsed Radiofrequency Treatment
Pain Clinics
Patient Rights
Pain Management
Back Pain
Low Back Pain
Local Anesthetics
Visual Analog Scale
Electrodes
Retrospective Studies
Outcome Assessment (Health Care)

Keywords

  • Ablation
  • Cervical spine
  • Chronic pain
  • Denervation
  • Dorsal rami
  • Lumbar spine
  • Medial branches
  • Pulsed radiofrequency waves
  • Zygapophyseal joint

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Pulsed radiofrequency application in treatment of chronic zygapophyseal joint pain. / Mikeladze, Georgi; Espinal, Ramon; Finnegan, Robert; Routon, James; Martin, Dan C.

In: Spine Journal, Vol. 3, No. 5, 01.09.2003, p. 360-362.

Research output: Contribution to journalArticle

Mikeladze, Georgi ; Espinal, Ramon ; Finnegan, Robert ; Routon, James ; Martin, Dan C. / Pulsed radiofrequency application in treatment of chronic zygapophyseal joint pain. In: Spine Journal. 2003 ; Vol. 3, No. 5. pp. 360-362.
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abstract = "Background context: Chronic zygapophyseal joint arthropathy is a cause of back and neck pain. One proposed method of treating facet joint pathology is ablation of medial branches and dorsal rami with pulsed radiofrequency (RF) waves. Purpose: Assessment of efficacy of pulsed RF application for treatment of chronic zygapophyseal joint pain. Study design/setting: Retrospective study of 114 patients at a pain management clinic. Patient Sample: A total of 114 patients with clinical signs of facet joint involvement and a favorable response to a diagnostic medial branch block using local anesthetic, including 82 females and 32 males with a mean age of 52.8±12.6 years. Mean duration of pain was 7.52±5.26 years. Twenty-seven had previous back surgery, 83 patients had low back pain and 31 had cervical pain. Pain was on the left side in 47 patients, on the right side in 45 patients, bilateral in 22. Outcome measures: Result was regarded as successful if pain reduction was more than 50{\%} on visual analog scale and the duration of effect was more than 1.5 months. Methods: After obtaining positive stimulation, pulsed RF was applied to medial branches of dorsal rami for 120 seconds with temperature at the tip of the electrode 42 C. Results: Of 114 patients, who had positive response to diagnostic block, 46 patients did not respond favorably to pulsed RF application (pain reduction less than 50{\%}). In 68 patients, the procedure was successful and lasted on average 3.93±1.86 months. Eighteen patients had the procedure repeated with the same duration of pain relief that was achieved initially. Previous surgery, duration of pain, sex, levels (cervical vs. lumbar) and stimulation levels did not influence outcomes. Conclusion: The results of our study showed that the application of pulsed RF to medial branches of the dorsal rami in patients with chronic facet joint arthropathy provided temporary pain relief in 68 of 118 patients.",
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