4.5 Review

Retrospective Review of the Efficacy of Lumbar Radiofrequency Ablation for Lumbar Facet Arthropathy: The Influence of Gender and Obesity

Journal

PAIN PHYSICIAN
Volume 26, Issue 6, Pages E695-E701

Publisher

AM SOC INTERVENTIONAL PAIN PHYSICIANS

Keywords

Low back pain; gender; lumbar radiofrequency ablation; obesity; facet joint

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This study evaluated the outcomes of patients undergoing lumbar radiofrequency ablation for lumbar facet joint pain. The results showed significant effectiveness of this treatment method. Gender and obesity were found to influence the treatment outcomes, indicating the need for further investigation.
Background: Lumbar facet arthropathy is one of the leading causes of back pain. Lumbar radiofrequency lesioning is a therapy for lumbar facet arthropathy that uses heat to ablate the transmission of nerve signals from the medial branches of the spinal nerves associated with the corresponding painful lumbar joints. Objectives: The present investigation evaluated the outcomes of patients undergoing lumbar radiofrequency ablation at an academic pain program with a special focus on the influence of gender and obesity. Study Design: Retrospective chart review. Setting: Academic tertiary care center. Methods: We reviewed the charts of 232 patients for age, body mass index, gender, other procedures, and complications, in addition to the primary outcome measurements of Visual Analog Scale pain scores, pain relief percentages, pain relief duration, and functional status improvement per patient report. Associations with outcomes were evaluated with correlations, t tests/analysis of variance, and chi 2 test. Influences on a change in Visual Analog Scale pain scores before and after treatment were assessed with linear regression. Results: Patients had an average pain reduction of 76.6% (SD = 24.5) from the initial treatment and an average of 30.7 weeks (SD = 21.2) of pain relief from the initial treatment. A total of 83% of the patients reported an improvement in functional status from the initial treatment. Women (mean = 79.8%, SD = 21.4) had a slightly higher pain relief percentage than men (mean = 71.6%, SD = 28.1; P = 0.046). A higher body mass index was associated with less improvement in Visual Analog Scale maximum pain scores from before and after the procedure (beta = 0.04; SE = 0.02; P = 0.042). Limitations: Our study is not a randomized controlled trial; however, based on the number of patients reviewed, our data provide important information regarding lumbar radiofrequency ablations. Conclusions: This study highlights significant effectiveness for patients undergoing lumbar radiofrequency ablations for lumbar facet joint pain. A variation in effectiveness appears to be influenced by gender and obesity, and therefore additional studies are warranted to further investigate these differences.

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