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Clinical Outcomes: Radiofrequency Ablation

Radiofrequency lesioning of the lumbar facet using the medial branch approach is the preferred treatment for providing long-lasting relief of lumbar facet joint pain.[1] Clinical studies show that radiofrequency neurotomy has long-term beneficial results. These include:

  • Significant pain relief for up to 2 years[2][3][4][5][6][7][8][9]
  • Significant and longer lasting pain relief compared to steroid injections[6]
  • Appreciable pain relief compared to surgery: Nearly half of back pain sufferers are not helped by surgery[9]
  • Greater range of motion[2][5][8]
  • Lower use of analgesics[2][5]
  • Improved quality of life[2]
  • Low complication and morbidity rates[2][5][6][7][8]

Documented Clinical Outcomes

A study by S Nath, CA Nath, and K Pettersson[10] showed that patients treated with radiofrequency neurotomy had statistically significant and lasting improvement in lower back and leg pain, as well as back and hip movement, quality of life, and use of analgesics.

Case reports by DS Fenton and LF Czervionke[11] stated that radiofrequency denervation resulted in 90% to 95% pain relief in their patients. They also describe the procedure as one of minimal risk that can be performed on an outpatient basis with very little sedation.

In a pilot study conducted by RS Burnham and Y Yasui,[12] all patients but one said they experienced pain relief, including significant reductions of pain frequency and severity and analgesic intake during the 1-year follow-up.

Using criteria established by the Agency for Healthcare Research and Quality (AHRQ), MV Boswell, JD Colson, N Sehgal, EE Dunbar, and R Epter[13] conducted a systematic review of the effectiveness of radiofrequency neurotomy in managing chronic spinal pain and concluded that evidence is moderate short- and long-term pain relief. Their review also found that the overall rate of complications, which were minor, was 1%.

P Dreyfuss, B Halbrook, K Pauza, A Joshi, J McLarty, and N Bogduk[14] audited 15 patients who underwent radiofrequency neurotomy for chronic lumbar facet joint pain and found that 60% reported at least 90% pain relief at 12 months and 87% reported at least 60% relief.

A retrospective study by R Arora[15] confirmed the effectiveness of radiofrquency neurotmy in patients where conservative treatments for chronic low back pain had failed. He reported that after undergoing the RF procedure 77% of patents experienced pain relief, 59% shoed improvement in sitting, 62% in standing, and 67% in walking.

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