Clinical predictors of success and failure for lumbar facet radiofrequency denervation. Clin J Pain 2007 Jan;23(1):45-52
Date
02/06/2007Pubmed ID
17277644DOI
10.1097/01.ajp.0000210941.04182.eaScopus ID
2-s2.0-33847117056 (requires institutional sign-in at Scopus site) 127 CitationsAbstract
OBJECTIVE: To determine the clinical factors associated with the success and failure of radiofrequency denervation of the lumbar facet joints.
METHODS: Clinical data were garnered from 3 academic medical centers on 192 patients with low back pain who underwent radiofrequency denervation after a positive response to diagnostic blocks. Success was defined as >/=50% pain relief lasting at least 6 months. Factors evaluated for their association with outcome included duration of pain, opioid use, symptom location, paraspinal tenderness, pain exacerbated by extension/rotation (ie, facet loading), MRI abnormalities, diabetes, smoking, scoliosis, obesity, prior surgery and levels treated.
RESULTS: The only factor associated with a successful outcome was paraspinal tenderness. Variables that correlated with treatment failure were 'facet loading,' long duration of pain, and previous back surgery.
CONCLUSIONS: It is counterproductive to use 'facet loading' as the sole basis for choosing patients for facet interventions. In patients at high risk for treatment failure, taking additional steps to reduce the rate of false-positive screening blocks may improve outcomes.
Author List
Cohen SP, Hurley RW, Christo PJ, Winkley J, Mohiuddin MM, Stojanovic MPAuthor
Robert W. Hurley MD, PhD Adjunct Professor of Anesthesiology and CTSI in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Denervation
Female
Humans
Low Back Pain
Lumbar Vertebrae
Male
Medical Records
Middle Aged
Prognosis
Time Factors
Treatment Outcome
Weight-Bearing
