DURATION OF THE RADIOFREQUENCY FACET DENERVATION AND THE OUTCOME OF THE TREATMENT: PROPECTIVE RANDOMIZED DOUBLE-BLINDED STUDY

AUTHORS: Y. Eugene Mironer, M.D., Carolinas Center For Advanced Management Of Pain Judson J. Somerville, M.D., The Pain Management Clinic of Laredo

Radiofrequency (RF) ablation of medial branch nerve block is a popular modality of treatment of the facet joint pain. Nevertheless, there is no universal opinion on the proper duration of applied RF current. Different literature sources suggested from 60 sec to 110 sec. The goal of this study we to determine the existence of relationship between the length of RF and the outcome of neurectomy. 

Methods:50 patients with facet joints pain syndrome, confirmed by intraacular and medial branch nerve blocks with local anesthetic, underwent RF denervation using standard protocol. Patients were ran- domly divided in two groups: one had RF current applied for 70 sec, the other-for 90 sec. The duration of RF was blinded from the patients and the operator. 

Results:25 out of 30 patients received more chan 50% relief of pain that lasted six months. 3 individuals in one group and 4 in the other didn't experience sufficient improvement. Six patients required repetitive RF within the first year of the procedure. They were equally divided between two groups. 

Discussion: Duration of the RF current in facet denervation has no impact on the outcome of the treatment. 

Conclusion: Shortest length of RF (60-70sec) can be used for medical branch nerve ablation. There is no scientific justification for extended application of Rf.