Optimal Temperature for Radiofrequency Ablation of Lumbar Medial Branches for Treatment of Facet-Mediated Back Pain.

Autor: Costandi S; Department of Pain Management, Cleveland Clinic, Cleveland, Ohio, U.S.A.; Evidence Based Pain Medicine Research, Cleveland Clinic, Cleveland, Ohio, U.S.A., Garcia-Jacques M; Department of Pain Management, Cleveland Clinic, Cleveland, Ohio, U.S.A., Dews T; Department of Pain Management, Cleveland Clinic, Cleveland, Ohio, U.S.A., Kot M; Department of General Anesthesiology, Cleveland Clinic, Cleveland, Ohio, U.S.A., Wong K; Department of General Anesthesiology, Cleveland Clinic, Cleveland, Ohio, U.S.A., Azer G; Evidence Based Pain Medicine Research, Cleveland Clinic, Cleveland, Ohio, U.S.A., Atalla J; Ohio State University, Columbus, Ohio, U.S.A., Looka M; Oakland University, Rochester, Michigan, U.S.A., Nasr E; Case Western Reserve University, Cleveland, Ohio, U.S.A., Mekhail N; Department of Pain Management, Cleveland Clinic, Cleveland, Ohio, U.S.A.; Evidence Based Pain Medicine Research, Cleveland Clinic, Cleveland, Ohio, U.S.A.
Jazyk: angličtina
Zdroj: Pain practice : the official journal of World Institute of Pain [Pain Pract] 2016 Nov; Vol. 16 (8), pp. 961-968. Date of Electronic Publication: 2015 Sep 15.
DOI: 10.1111/papr.12346
Abstrakt: Background: Radiofrequency ablation (RFA) of the medial branch nerves that innervate the facet joints is a well-established treatment modality; however, studies to determine the optimal radiofrequency ablation temperature are lacking. A wide range (70 to 90°C) has been used. This study aimed to compare outcomes with two set temperatures for the lumbar facet medial branch ablation, 90 and 80°C.
Methods: This retrospective study compared the degree of patient self-reported functional improvement relief, postoperative opioid dose changes, as well as duration among lumbar facet medial branch (RFA) patients who had the procedures performed at 80 or 90°C.
Results: Patients who underwent the procedure at 90°C had 3.1 (95% CI 1.7, 6.5) times the odds (P = 0.0004) of reporting functional improvement of at least 50% when compared to those who underwent neurotomy at 80°C. For self-reported functional improvement greater or equal to 75%, the results were sustained with an odds ratio of 2.8 (95% CI 1.2, 5.7) favoring those with 90°C temperature neurotomy (P = 0.002).
Conclusion: There seems to be significant functional improvement associated with temp of 90°C compared to 80°C, with no added risk of complications. Randomized controlled studies are warranted.
(© 2015 World Institute of Pain.)
Databáze: MEDLINE
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