Effect of pulsed radiofrequency treatment on thoracic medial branch for managing chronic thoracic facet joint pain refractory to medial branch block with local anesthetics.

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Effect of pulsed radiofrequency treatment on thoracic medial branch for managing chronic thoracic facet joint pain refractory to medial branch block with local anesthetics.

World Neurosurg. 2017 Dec 30;:

Authors: Chang MC

Abstract
OBJECTIVE: We evaluated the effect of pulsed radiofrequency (PRF) stimulation of the thoracic medial branch of the dorsal ramus in patients with chronic TFJ pain who were refractory to medial branch block (MBB).
METHODS: This was a prospective observational study. We retrospectively reviewed data from 72 patients who had received therapeutic MBB with 0.5 mL of 2% lidocaine mixed with 0.5 mL of 0.25% bupivacaine to treat TFJ-origin upper or mid back pain. Of these patients, 20 were included to evaluate the effects of PRF on the thoracic medical branch to manage TFJ pain refractory to therapeutic MBB. PRF stimulation was administered at 5 Hz and a 5-ms pulsed width for 360s at 45 V. The pain-reducing effect of the PRF procedure was evaluated using the numeric rating scale (NRS) at 1, 2, and 3 months after treatment. Successful pain relief was defined as ≥ 50% reduction in the NRS score compared with the score prior to treatment.
RESULTS: The NRS scores changed significantly over time (pretreatment, 6.0 ± 1.0; 1 month, 3.3 ± 2.2; 2 months, 3.9 ± 2.1; and 3 months, 4.0 ± 2.2). At 1, 2, and 3 months after PRF procedure, the NRS scores were significantly reduced compared with the scores before the treatment. Eleven (55%) of the 20 patients reported successful pain relief at 3 months after PRF.
CONCLUSIONS: We suggest that PRF on the thoracic medial branch is an effective and safe interventional technique for the control of chronic TFJ pain.

PMID: 29294395 [PubMed - as supplied by publisher]

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