Omar Rachdi , Andrew Stephens , Amanda N. Cooper , Brook Martin , Robert Burnham , Aaron M. Conger , Zachary L. McCormick , Taylor R. Burnham
{"title":"一项回顾性单臂队列研究评估腰椎内侧支射频消融的疗效，采用多线探针和垂直入路","authors":"Omar Rachdi , Andrew Stephens , Amanda N. Cooper , Brook Martin , Robert Burnham , Aaron M. Conger , Zachary L. McCormick , Taylor R. Burnham","doi":"10.1016/j.inpm.2025.100575","DOIUrl":null,"url":null,"abstract":"<div><h3>Summary of background data</h3><div>Lumbar medial branch radiofrequency ablation (LMBRFA) is an effective treatment for facet joint pain. LMBRFA efficacy was originally demonstrated using a parallel technique. Newly developed RFA probes (<em>e.g.</em>, Trident) allow a perpendicular approach (P-LMBRFA), which may simplify the RFA technique and lead to superior treatment success rates. However, further investigation is necessary to determine whether these technologies are associated with improved patient outcomes.</div></div><div><h3>Objectives</h3><div>Evaluate the effectiveness of P-LMBRFA in patients with confirmed facet pain.</div></div><div><h3>Methods</h3><div>In this retrospective single-arm cohort study, electronic medical records were used to identify consecutive patients with ≥80 % dual medial branch block-confirmed pain relief who underwent first-time P-LMBRFA between 2016 and 2022. Primary outcomes were ≥50 % Numerical Rating Scale (NRS) pain improvement and the minimal clinically important difference (MCID) on the Pain Disability Quality-of-Life Questionnaire (PDQQ) at 3 months post-treatment. Secondary outcomes included the duration and mean retrospective percentage of pain relief after a successful index P-LMBRFA in individuals who reported a return of their index symptoms.</div></div><div><h3>Results</h3><div>174 participants (60.3 % female, 61.3 ± 14.2 years of age, BMI 29.5 ± 6.7 kg/m<sup>2</sup>) were analyzed. Success rates for ≥50 % NRS reduction and MCID on the PDQQ at 3 months were 50.6 % (95 % CI = 43.3–57.9 %) and 50.0 % (95 % CI = 42.8–57.2 %), respectively. Of the 88 successful P-LMBRFAs, 60 patients experienced a return of symptoms after 8.7 ± 3.6 months and reported a retrospective mean percentage pain relief of 81.8 % ± 15.8 %.</div></div><div><h3>Discussion/conclusion</h3><div>Following P-LMBRFA, approximately 50 % of patients reported improvement in pain and disability measures. Extensive, prospective research comparing long-term outcomes of P-LMBRFA and parallel LMRBFA is warranted.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100575"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A retrospective single arm cohort study evaluating the efficacy of lumbar medial branch radiofrequency ablation using a multi-tined probe and perpendicular approach\",\"authors\":\"Omar Rachdi , Andrew Stephens , Amanda N. Cooper , Brook Martin , Robert Burnham , Aaron M. Conger , Zachary L. McCormick , Taylor R. Burnham\",\"doi\":\"10.1016/j.inpm.2025.100575\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Summary of background data</h3><div>Lumbar medial branch radiofrequency ablation (LMBRFA) is an effective treatment for facet joint pain. LMBRFA efficacy was originally demonstrated using a parallel technique. Newly developed RFA probes (<em>e.g.</em>, Trident) allow a perpendicular approach (P-LMBRFA), which may simplify the RFA technique and lead to superior treatment success rates. However, further investigation is necessary to determine whether these technologies are associated with improved patient outcomes.</div></div><div><h3>Objectives</h3><div>Evaluate the effectiveness of P-LMBRFA in patients with confirmed facet pain.</div></div><div><h3>Methods</h3><div>In this retrospective single-arm cohort study, electronic medical records were used to identify consecutive patients with ≥80 % dual medial branch block-confirmed pain relief who underwent first-time P-LMBRFA between 2016 and 2022. Primary outcomes were ≥50 % Numerical Rating Scale (NRS) pain improvement and the minimal clinically important difference (MCID) on the Pain Disability Quality-of-Life Questionnaire (PDQQ) at 3 months post-treatment. Secondary outcomes included the duration and mean retrospective percentage of pain relief after a successful index P-LMBRFA in individuals who reported a return of their index symptoms.</div></div><div><h3>Results</h3><div>174 participants (60.3 % female, 61.3 ± 14.2 years of age, BMI 29.5 ± 6.7 kg/m<sup>2</sup>) were analyzed. Success rates for ≥50 % NRS reduction and MCID on the PDQQ at 3 months were 50.6 % (95 % CI = 43.3–57.9 %) and 50.0 % (95 % CI = 42.8–57.2 %), respectively. Of the 88 successful P-LMBRFAs, 60 patients experienced a return of symptoms after 8.7 ± 3.6 months and reported a retrospective mean percentage pain relief of 81.8 % ± 15.8 %.</div></div><div><h3>Discussion/conclusion</h3><div>Following P-LMBRFA, approximately 50 % of patients reported improvement in pain and disability measures. Extensive, prospective research comparing long-term outcomes of P-LMBRFA and parallel LMRBFA is warranted.</div></div>\",\"PeriodicalId\":100727,\"journal\":{\"name\":\"Interventional Pain Medicine\",\"volume\":\"4 2\",\"pages\":\"Article 100575\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Interventional Pain Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2772594425000366\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Interventional Pain Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2772594425000366","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景资料概述：侧壁内侧支射频消融术（LMBRFA）是治疗小关节疼痛的有效方法。LMBRFA的有效性最初是通过平行技术证明的。新开发的RFA探针（如Trident）允许垂直入路（P-LMBRFA），这可能简化RFA技术并导致更高的治疗成功率。然而，需要进一步的研究来确定这些技术是否与改善患者预后有关。目的评价P-LMBRFA治疗关节突疼痛的疗效。方法在这项回顾性单臂队列研究中，使用电子病历识别2016年至2022年期间首次接受P-LMBRFA治疗的连续患者，其双内侧分支阻滞证实疼痛缓解≥80%。主要结局是治疗后3个月，数值评定量表（NRS）疼痛改善≥50%，疼痛残疾生活质量问卷（PDQQ）的最小临床重要差异（MCID）。次要结局包括报告其指数症状恢复的个体在P-LMBRFA治疗成功后疼痛缓解的持续时间和平均回顾性百分比。结果共纳入174例患者，其中女性60.3%，年龄61.3±14.2岁，BMI 29.5±6.7 kg/m2。3个月时PDQQ NRS降低≥50%和MCID的成功率分别为50.6% （95% CI = 43.3 - 57.9%）和50.0% （95% CI = 42.8 - 57.2%）。在88例成功的p - lmbrfa中，60例患者在8.7±3.6个月后出现症状复发，并报告回顾性平均疼痛缓解百分比为81.8%±15.8%。讨论/结论在P-LMBRFA治疗后，大约50%的患者报告疼痛和残疾指标得到改善。有必要进行广泛的前瞻性研究，比较P-LMBRFA和平行LMRBFA的长期疗效。
A retrospective single arm cohort study evaluating the efficacy of lumbar medial branch radiofrequency ablation using a multi-tined probe and perpendicular approach
Summary of background data
Lumbar medial branch radiofrequency ablation (LMBRFA) is an effective treatment for facet joint pain. LMBRFA efficacy was originally demonstrated using a parallel technique. Newly developed RFA probes (e.g., Trident) allow a perpendicular approach (P-LMBRFA), which may simplify the RFA technique and lead to superior treatment success rates. However, further investigation is necessary to determine whether these technologies are associated with improved patient outcomes.
Objectives
Evaluate the effectiveness of P-LMBRFA in patients with confirmed facet pain.
Methods
In this retrospective single-arm cohort study, electronic medical records were used to identify consecutive patients with ≥80 % dual medial branch block-confirmed pain relief who underwent first-time P-LMBRFA between 2016 and 2022. Primary outcomes were ≥50 % Numerical Rating Scale (NRS) pain improvement and the minimal clinically important difference (MCID) on the Pain Disability Quality-of-Life Questionnaire (PDQQ) at 3 months post-treatment. Secondary outcomes included the duration and mean retrospective percentage of pain relief after a successful index P-LMBRFA in individuals who reported a return of their index symptoms.
Results
174 participants (60.3 % female, 61.3 ± 14.2 years of age, BMI 29.5 ± 6.7 kg/m2) were analyzed. Success rates for ≥50 % NRS reduction and MCID on the PDQQ at 3 months were 50.6 % (95 % CI = 43.3–57.9 %) and 50.0 % (95 % CI = 42.8–57.2 %), respectively. Of the 88 successful P-LMBRFAs, 60 patients experienced a return of symptoms after 8.7 ± 3.6 months and reported a retrospective mean percentage pain relief of 81.8 % ± 15.8 %.
Discussion/conclusion
Following P-LMBRFA, approximately 50 % of patients reported improvement in pain and disability measures. Extensive, prospective research comparing long-term outcomes of P-LMBRFA and parallel LMRBFA is warranted.
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