Radiofrequency Ablation of the Thoracic Descending Branch of the Posterior Rami: An Effective Intervention for Facet Joint Pain. A Case Report.

Abstract

Background: Thoracic spine pain is believed to have a comparable prevalence to that of neck pain and low back pain in the general population. Recent discoveries in thoracic spine neuroanatomy have shown that the descending branch of the posterior ramus innervates the thoracic facet joint capsule. We present a case in which thermal radiofrequency ablation of the descending branch was used to significantly relieve pain in a patient with thoracic facet joint pain.

Case report: A 57-year-old woman presented with a 4-month history of severe midthoracic back pain. The patient had failed initial conservative treatment including oral pain medications and physical therapy for 3 months. She ultimately elected for 2 bilateral diagnostic blocks of the T4-T6 descending branches and subsequent radiofrequency ablation; this treatment resulted in complete pain relief and functional improvement.

Conclusions: Thoracic spine descending branch thermal radiofrequency ablation may be a treatment option for thoracic facet joint pain.