A Randomized Prospective Trial of Cooled Versus Traditional Radiofrequency Ablation of the Medial Branch Nerves for the Treatment of Lumbar Facet Joint Pain
Autor: | Masaru Teramoto, Dost Khan, Zachary L McCormick, David R. Walega, Heejung Choi, Geeta Nagpal, Raafay H. Syed, Meghan Bhave, Rajiv Reddy, Mark C. Kendall |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Adult
Male Radiofrequency ablation Physical function Article Zygapophyseal Joint law.invention Lumbar Randomized controlled trial law Medicine Humans Single-Blind Method Prospective Studies Prospective cohort study Aged Lumbar facet joint pain Lumbar Vertebrae business.industry General Medicine Middle Aged Arthralgia Oswestry Disability Index Anesthesiology and Pain Medicine surgical procedures operative Treatment Outcome Prospective trial Cryotherapy Anesthesia Catheter Ablation Female business therapeutics Follow-Up Studies |
Popis: | 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. |
Databáze: | OpenAIRE |
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