Search

INTRODUCTION: Chronic low back pain is a major source of disability and work productivity loss worldwide. Treatment modalities for back pain due to facet joint arthropathy include chemical neurolysis (Ethyl Alcohol or Glycerol) and radiofrequency denervation of lumbar facet joints. Long-term outcome of these semi-invasive techniques, however, are currently unclear. We hypothesize that radiofrequency denervation is associated with superior pain abolishment and less complications than chemical neurolysis. METHODS: For this prospective follow-up study, we enrolled patients between 01.12.2017 and 01.12.2019. Adult patients with recurrent chronic low back pain, resistant to non-invasive therapy and steroids injections were included. Spinal imaging was performed to exclude alternative diagnoses. Patients were grouped based on treatment modality. The following groups were compared: radiofrequency denervation (Gr. RFD), chemical neurolysis with Ethyl-Alcohol 95% (Gr. EA-95), or Glycerol 20% (Gr. Gly-20). The Core Outcome Measures Index for the back (COMI), World Health Organization (WHO) pain ladder level and VAS (Visual Analog Scale) scores were determined. Furthermore, complications were documented and compared between groups. The outcome was determined pre-interventional, after 6 weeks, 6 and 12 months. RESULTS: A total of 95 patients (60 females and 35 males) with a mean age of 63.7 years were included. Prior to intervention, a mean COMI score of 8.31 and a VAS score of 8.01 were encountered. A total of 30 patients underwent RFD; 35 patients were treated with EA-95; and 35 patients were exposed to Glycerol 20% neurolysis. Subjects had an average WHO pain ladder level of 1.39. No statistically significant differences were found between the three groups. However, upon intervention, patients treated with RFD had significantly lower VAS levels compared to those treated with Ethyl Alcohol after 6 weeks (VAS: 4.33 vs. 6.12, (P<0.05)). Furthermore, after 6 months, bot

BACKGROUND It was hypothesized that radiofrequency denervation (RFD) of lumbar facet joints is associated with superior pain abolishment and less complications than chemical neurolysis (with ethyl alcohol or glycerol) in patients with chronic facet joint arthropathy. METHODS For this prospective cohort study, adult patients with chronic lumbar facet joint arthropathy were prospectively enrolled between 2017 and 2019. The following groups were compared before the intervention and 6 weeks, 6 months, and 12 months after the intervention: RFD, chemical neurolysis with ethyl alcohol 95% (EA-95), or glycerol 20% (Gly-20). Outcome parameters included the Core Outcome Measures Index for the back (COMI-back), World Health Organization (WHO) pain ladder level, and visual analog scale (VAS). P values <0.05 were considered statistically significant. RESULTS A total of 95 patients with a mean age of 63.7 years were included. Among them, 30 patients underwent RFD, 30 patients were treated with EA-95, and 35 individuals were treated with Gly-20. After 6 weeks, RFD patients had significantly lower VAS scores compared with the EA-95 group. After 6 months, both VAS and COMI were significantly lower in RFD patients than in the Gly-20 group. Twelve months after intervention, VAS scores were significantly lower in the RFD group compared with the Gly-20 group. CONCLUSIONS This study reveals that RFD is associated with improved pain relief and quality of life compared with chemical neurolysis for facet joint-related chronic lower back pain and should be considered as the treatment of choice in patients with chronic low back pain due to facet joint arthropathy. CLINICAL RELEVANCE The current study provides information that may improve clinical decision making in the treatment of chronic lumbar facet joint arthropathy and to appropriately counsel such patients about expected outcomes.