The effectiveness of cervical medial branch radiofrequency neurotomy using a perpendicular approach with a three-tined probe: A single-arm, retrospective cohort study

David Civitarese , Andrew Stephens , Timothy M. Curtis , Chase Young , Alexa G. Ries , Amanda N. Cooper , Brook Martin , Alycia Amatto , Robert S. Burnham , Aaron M. Conger , Zachary L. McCormick , Taylor R. Burnham
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Abstract

Background

Cervical medial branch radiofrequency neurotomy (CMBRFN) with a parallel approach has been proven to be an effective treatment for zygapophyseal joint-mediated cervical pain. Technological advancements in radiofrequency probe design have allowed for a perpendicular approach to electrode placement. However, the effectiveness of the perpendicular approach remains to be fully understood.

Objectives

Evaluate the effectiveness of CMBRFN with a perpendicular approach (pCMBRFN) in patients with confirmed zygapophyseal joint-mediated cervical pain.

Methods

This single-arm, retrospective cohort study included patients identified between 2016 and 2022 who underwent pCMBRFN after demonstrating ≥80 % pain relief with two consecutive diagnostic medial branch blocks (MBB). Primary outcomes were ≥50 % patient-reported numeric rating scale (NRS) pain relief and minimal clinically important difference (MCID) on the Pain Disability Quality-Of-Life Questionnaire-Spine (PDQQ-S) at 3 months post-procedure. Secondary outcomes were mean patient-reported retrospective percentage pain relief and duration of relief after a successful pCMBRFN in individuals who presented for repeat pCMBRFN upon return of their symptoms.

Results

A total of 52 participants (63.5 % female; mean age 55.9 ± 10.9 years; mean BMI 26.8 ± 5.2 kg/m2) were analyzed. At 3 months post-procedure, ≥50 % NRS pain reduction and MCID on PDQQ-S were both reported by 34 patients (65.4 % [95%CI 51.8–76.9]). Of the 34 patients with successful treatment response, 15 had return of symptoms after an average of 8.8 ± 2.5 months with a reported mean percentage pain relief of 86.0 ± 14.9 %.

Conclusion

Within this cohort, pCMBRFN demonstrated effectiveness by reducing pain and disability in over 65 % of patients with confirmed cervical zygapophyseal joint-mediated pain at 3 months. Patients with successful treatment outcomes whose index symptoms eventually returned reported an average pain reduction of 86 % lasting approximately 9 months. Larger prospective studies with long-term follow-up are needed to confirm these results.
颈椎内侧支射频神经切开术的有效性:一项单臂、回顾性队列研究
背景颈椎内侧支射频神经切开术(CMBRFN)平行入路已被证明是治疗关节关节介导的颈椎疼痛的有效方法。射频探针设计的技术进步使得电极的垂直放置成为可能。然而,垂直方法的有效性仍有待充分了解。目的评价垂直入路CMBRFN (pCMBRFN)在确诊的关节关节介导性颈痛患者中的疗效。方法:这项单臂、回顾性队列研究纳入了2016年至2022年间确定的患者,这些患者在连续两次诊断性内侧分支阻滞(MBB)治疗后疼痛缓解≥80%,并接受了pCMBRFN治疗。主要结局是术后3个月患者报告的数字评定量表(NRS)疼痛缓解≥50%,疼痛残疾生活质量问卷-脊柱(pdq - s)最小临床重要差异(MCID)。次要结局是在症状复发后再次进行pCMBRFN治疗的患者,在成功进行pCMBRFN治疗后患者报告的平均回顾性疼痛缓解百分比和缓解持续时间。结果共52例受试者,其中女性63.5%;平均年龄55.9±10.9岁;平均BMI(26.8±5.2 kg/m2)。术后3个月,34例患者报告NRS疼痛减轻≥50%,PDQQ-S的MCID均为65.4% (95%CI 51.8-76.9)。在34例治疗成功的患者中,15例在平均8.8±2.5个月后症状复发,报告的平均疼痛缓解百分比为86.0±14.9%。在该队列中,pCMBRFN在3个月时通过减轻65%以上确诊颈椎关节关节介导性疼痛的患者的疼痛和残疾显示出有效性。治疗结果成功的患者,其指数症状最终恢复,平均疼痛减轻86%,持续约9个月。需要更大规模的长期随访前瞻性研究来证实这些结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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