Radiofrequency neurolysis for facet arthropathy: a retrospective case series and review of the literature.

Pain practice : the official journal of World Institute of Pain · 2002 · Benefit · Very low evidence

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BenefitVery low evidencePaper 3792

Study snapshot

PublicationPain practice : the official journal of World Institute of Pain · 2002

Study typecase_report

Reported directionBenefit

Evidence ratingVery low

Abstract

CONTEXT: Facet arthropathy is a common cause of spine-related pain. Typically resulting from spondylosis, trauma, including surgical trauma or post surgical stress is also a significant cause. Radiofrequency thermocoagulation or neurolysis may be an effective modality providing long-term improvement. OBJECTIVES: To evaluate the success rates for radiofrequency neurolysis for facet arthropathy in a large retrospective case series in a single pain practice setting. DESIGN: A retrospective case series involving chart reviews and patient follow-up visits or telephone contacts of radiofrequency neurolytic procedures performed for facet arthropathy over a 4-year period. SETTING: Private practice pain clinic with academic affiliation in Tulsa, OK. PARTICIPANTS: One hundred forty eight patients with confirmed facet arthropathy refractory to conservative measures underwent 230 radiofrequency neurolysis procedures and were followed for a minimum of 1 year post procedure. For cervical facet procedures: 63 patients (106 procedures); age range F: 27-84 years old; M: 33-65 years old. For lumbar facet procedures: 85 patients (124 facet procedures); age range F: 19-81 years old; M: 20-77 years old. MAIN OUTCOME MEASURES: After the radiofrequency procedure, patients were followed with periodic visits or telephone contacts. Outcome measures were McGill short form pain questionnaire, VAS pain scores, muscle spasm scores, tenderness, range of motion and patient subjective global responses. RESULTS: Subjective patient responses were graded as follows: excellent:greater than 70% improvement, good: 50% to 70% improvement, fair: 30% to 49%, and poor: less than 30%. One hundred six radiofrequency procedures were performed in the 63 cervical cases and 124 in the 85 lumbar cases with those patients who had good to excellent responses undergoing repeat procedures. Of the patients with cervical facet radiofrequency procedures, 38 (37%), 51 (48%), 4 (3%) and 13 (12%) had excellent, good, fair or poor responses, respectively. Of the lumbar facet radiofrequency cases, 37 (30%), 52 (41%), 13 (10%) and 22 (19%) had excellent, good, fair or poor responses, respectively. Excellent responders noted an average duration of 10.8 months (range 3-34 months before dropping below 70% improvement level) for cervical cases and 7.9 months (range 3-20) for lumbar. Good responders noted an average duration of 6.5 months (range 3-22 months before dropping below 50% improvement level) for cervical and 6.8 months (range 3-48) for lumbar radiofrequency procedures. No significant side effects were experienced (short-term neuritis was seen in 2 patients who had cervical and 1 who had lumbar RFTC, but resolved in each case after a few weeks). CONCLUSIONS: In summary, 85% of cervical and 71% of lumbar RFTC cases had at least a 50% improvement in symptoms for extended periods. RFTC of median branches for facet arthropathy is a safe and efficacious modality with the potential for long-term benefit.

Machine Enhanced Logic

AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typecase_report

Effect directionbenefit

PopulationPatients with confirmed cervical or lumbar facet arthropathy refractory to conservative measures treated in a private practice pain clinic (Tulsa, OK).

Sample size148

Exposurefollowed for a minimum of 1 year post procedure; reported response durations ranged 3–48 months depending on response category and site

Evidence strengthVery lowConfidence: 74% · Peer reviewed: yes

Main findings

In this retrospective case series (148 patients; 230 procedures), most procedures were associated with patient-reported improvement: cervical cases had 37% excellent and 48% good responses; lumbar cases had 30% excellent and 41% good responses. The authors report that 85% of cervical and 71% of lumbar cases had at least 50% symptom improvement for extended periods, with short-term neuritis reported in 3 patients and no other significant side effects noted.

Outcomes measured

Pain (McGill short form pain questionnaire)
VAS pain scores
Muscle spasm scores
Tenderness
Range of motion
Patient subjective global response
Adverse effects/side effects (e.g., short-term neuritis)

Limitations

Retrospective case series design (no randomization or control group described)
Single private practice setting
Outcomes include subjective patient responses and telephone follow-up contacts

View raw extracted JSON

{
  "study_type": "case_report",
  "exposure": {
    "band": null,
    "source": "radiofrequency neurolysis (radiofrequency thermocoagulation)",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": "followed for a minimum of 1 year post procedure; reported response durations ranged 3–48 months depending on response category and site"
  },
  "population": "Patients with confirmed cervical or lumbar facet arthropathy refractory to conservative measures treated in a private practice pain clinic (Tulsa, OK).",
  "sample_size": 148,
  "outcomes": [
    "Pain (McGill short form pain questionnaire)",
    "VAS pain scores",
    "Muscle spasm scores",
    "Tenderness",
    "Range of motion",
    " Patient subjective global response",
    "Adverse effects/side effects (e.g., short-term neuritis)"
  ],
  "main_findings": "In this retrospective case series (148 patients; 230 procedures), most procedures were associated with patient-reported improvement: cervical cases had 37% excellent and 48% good responses; lumbar cases had 30% excellent and 41% good responses. The authors report that 85% of cervical and 71% of lumbar cases had at least 50% symptom improvement for extended periods, with short-term neuritis reported in 3 patients and no other significant side effects noted.",
  "effect_direction": "benefit",
  "limitations": [
    "Retrospective case series design (no randomization or control group described)",
    "Single private practice setting",
    "Outcomes include subjective patient responses and telephone follow-up contacts"
  ],
  "evidence_strength": "very_low",
  "confidence": 0.74,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "facet arthropathy",
    "spine-related pain",
    "radiofrequency thermocoagulation",
    "radiofrequency neurolysis",
    "RFTC",
    "cervical facet",
    "lumbar facet",
    "pain outcomes",
    "case series"
  ],
  "suggested_hubs": []
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.1046/j.1533-2500.2002.02004.x
PubMed: 17134469

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