Disclosures: Carlo J. Milani, MD, MBA: No financial relationships or conflicts of interest
Objective: This study aimed to (1) evaluate the association of a positive response to medial branch blocks (MBBs) (1 versus 2 blocks) with clinical response to cervical or lumbar radiofrequency ablation (RFA); and (2) assess for clinical factors that may be associated with a positive response to RFA
Design: Retrospective study. Setting : Tertiary academic setting. Participants : Fifty-two patients with a positive response to MBBs for chronic neck or low back pain who then underwent cervical or lumbar RFA, respectively, from February 2016 to October 2017.
Interventions: Data were collected from electronic medical records and included patient demographics, medical history, clinical exam findings, and procedure details.
Main Outcome Measures: An overall percentage of improvement following RFA was either provided directly by the patient or calculated using pre- and post-procedure pain scores up to 1.5 years post-procedure. Patients were grouped into < 90% or ≥90% improvement.
Results: Thirty-two patients reported < 90% improvement, and 20 reported ≥90% improvement. Of the < 90% responders, 8 reported < 50% improvement after RFA. There was no difference in attaining ≥90% improvement between those who received 1 versus 2 positive diagnostic MBBs prior to RFA. History of “stiffness” on review of systems was negatively associated with ≥90% improvement post-RFA (p=0.029). History of “headache” was positive associated with ≥90% improvement post-RFA (p=0.013) for both the cervical and lumbar spine. Conclusions: MBBs may improve the diagnosis of facet-mediated spinal pain, but there appears to be no additional prognostic value in 2 positive MBBs over 1 positive MBB prior to RFA. Some patient factors on history may help predict response to RFA. Reducing the number of unnecessary procedures for patients reduces the risk of adverse events and provides cost-savings to the healthcare system.
Level of Evidence: Level IV
To cite this abstract in AMA style:
Milani CJ, Hurwitz N, Cheng J, Kirschner JS. Retrospective Review of Cervical and Lumbar Radiofrequency Ablation: Association of Patient-Reported Pain Relief After Response to 1 vs. 2 Medial Branch Blocks and Other Clinical Patient Factors [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/retrospective-review-of-cervical-and-lumbar-radiofrequency-ablation-association-of-patient-reported-pain-relief-after-response-to-1-vs-2-medial-branch-blocks-and-other-clinical-patient-factors/. Accessed May 14, 2025.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/retrospective-review-of-cervical-and-lumbar-radiofrequency-ablation-association-of-patient-reported-pain-relief-after-response-to-1-vs-2-medial-branch-blocks-and-other-clinical-patient-factors/