Effectiveness of Repeated Radiofrequency Neurotomy for Cervical Facet Joint Pain
- 1 August 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Spinal Disorders & Techniques
- Vol. 21 (6), 406-408
- https://doi.org/10.1097/bsd.0b013e318158971f
Abstract
Retrospective chart review. To determine the success rate and duration of relief of repeat radiofrequency neurotomy (RFN) for cervical facet joint pain. RFN is an effective but temporary management of cervical facet pain. When pain recurs, RFN is usually repeated, but the outcomes for repeat RFN are not well established. Record review of consecutive patients who had an initial successful RFN, recurrence of pain, and then one or more repeat RFN. Responses of repeat RFN were compared with initial RFN for success rates and duration of relief. Success was defined as >/=50% relief of targeted pain and patient sufficiently satisfied with prior RFN to have RFN repeated. There were 14 women and 8 men. Mean age was 47 years (range, 34 to 66 y). Sixty-four RFNs were performed. Mean duration of relief after initial RFN was 12.5 months (range, 3 to 25 mo). Forty-two RFNs were performed after the initial RFN. Forty-one of the 42 RFNs were available to follow-up (98%). Thirty-nine of the 41 RFNs were successful (95%). To date, 11 patients had a series of 2 RFNs performed, 7 had 3, 2 had 4, 1 had 6, and 1 had 7. Twenty-two patients had a second RFN, which was successful in 20 of the 21 available to follow-up (95%) but unsuccessful in 1 (5%). The mean duration of relief in these patients was 12.7 months (range, 3 to 30 mo) and the relief is continuing in 2 patients. Eleven patients had a third RFN, of which 10 (91%) were successful and 1 (9%) was unsuccessful. The mean duration of relief in 8 patients was 9.5 months (range, 3 to 16 mo), and the relief is continuing in the other 2. Four patients had a fourth RFN, which was successful in all 4. The mean duration of relief was 8.75 months (range, 4 to 12 mo). Two patients had a fifth RFN with both having a mean duration of relief of 9 months (11 and 7 mo, respectively). There were 2 patients with a sixth RFN, both were successful, 1 lasted 18 months and in the other relief is continuing. There was 1 patient with a successful seventh RFN, and relief is continuing. The frequency of success and durations of relief remained consistent after each subsequent RFN. In a carefully selected group of patients with cervical facet joint pain who have been responsive to previous RFN, repeat RFNs are usually successful.This publication has 9 references indexed in Scilit:
- Percutaneous Radiofrequency Neurotomy for Chronic Neck Pain: Outcomes in a Series of Consecutive PatientsPain Medicine, 2005
- Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scalePain, 2001
- Radiofrequency Medial Branch Neurotomy in Litigant and Nonlitigant Patients With Cervical WhiplashSpine, 2001
- Crash Characteristics of Whiplash Associated Chronic Neck PainJournal of Musculoskeletal Pain, 2000
- Percutaneous Radio-Frequency Neurotomy for Chronic Cervical Zygapophyseal-Joint PainThe New England Journal of Medicine, 1996
- Chronic Cervical Zygapophysial Joint Pain After WhiplashSpine, 1996
- Comparative local anaesthetic blocks in the diagnosis of cervical zygapophysial joint painPain, 1993
- False-Positive Rates of Cervical Zygapophysial Joint BlocksThe Clinical Journal of Pain, 1993
- The Prevalence of Cervical Zygapophyseal Joint Pain; A First ApproximationSpine, 1992