Background & Aims

Chronic lumbar facet pain poses a significant challenge in pain management, necessitating innovative approaches for effective relief. This case series investigates the feasibility and outcomes of Cooled Radiofrequency Ablation (RFA) without a prior diagnostic block in managing lumbar facet pain. Traditional approaches often involve diagnostic blocks before therapeutic interventions, but their efficacy remains debated. Our aim is to explore the potential of Cooled RFA as a primary intervention and assess its impact on pain relief and functional improvement.

Methods

We conducted a retrospective analysis of patients with chronic lumbar facet pain who underwent Cooled RFA without preceding diagnostic blocks. A total of 123 patients were included, with thorough pre-procedural assessments to confirm facet joint involvement. Cooled RFA was performed using Coolief(TM) equipment under fluoroscopic guidance. Outcome measures included pain scores, functional assessments, and any adverse events during a follow-up period of 6 months to four years.

Results

Our findings reveal promising outcomes following Cooled RFA without diagnostic blocks for lumbar facet pain. The average pain score decreased significantly from baseline, showcasing a clinically as well as statistically significant reduction. Functional assessments demonstrated improved mobility and quality of life in 99 percent of the cases. Importantly, minimal adverse events were reported during the follow-up period, emphasizing the safety profile of this approach.

Conclusions

This case series suggests that Cooled RFA, administered without prior diagnostic blocks, is a viable and effective intervention for chronic lumbar facet pain. The results highlight its potential to provide sustained pain relief and enhance functionality in patients with facet joint involvement. The findings challenge the conventional practice of diagnostic blocks preceding RFA, paving the way for a streamlined and efficient approach to managing lumbar facet pain.

References

1. Manchikanti L, Hirsch JA, Cohen SP, et al. Assessment of methodologic quality of randomized trials of interventional techniques: development of an interventional pain management specific instrument. Pain Physician. 2014;17(3):E263-E290.

2. Nath S, Nath CA, Pettersson K. Percutaneous lumbar zygapophysial (Facet) joint neurotomy using radiofrequency current, in the management of chronic low back pain: a randomized double-blind trial. Spine (Phila Pa 1976). 2008;33(12):1291-1298. doi:10.1097/BRS.0b013e31817329f0

Presenting Author

Sidharth Verma

Poster Authors

Sidharth Verma

DY Patil University, Navi Mumbai?

Lead Author

E-mail

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Low Back Pain