Husted Daniel S, Orton Derek, Schofferman Jerome, Kine Garrett
South Florida Orthopaedics and Sports Medicine, Stuart, FL, USA.
J Spinal Disord Tech. 2008 Aug;21(6):406-8. doi: 10.1097/BSD.0b013e318158971f.
Retrospective chart review.
To determine the success rate and duration of relief of repeat radiofrequency neurotomy (RFN) for cervical facet joint pain.
RFN is an effective but temporary management of cervical facet pain. When pain recurs, RFN is usually repeated, but the outcomes for repeat RFN are not well established.
Record review of consecutive patients who had an initial successful RFN, recurrence of pain, and then one or more repeat RFN. Responses of repeat RFN were compared with initial RFN for success rates and duration of relief. Success was defined as >/=50% relief of targeted pain and patient sufficiently satisfied with prior RFN to have RFN repeated.
There were 14 women and 8 men. Mean age was 47 years (range, 34 to 66 y). Sixty-four RFNs were performed. Mean duration of relief after initial RFN was 12.5 months (range, 3 to 25 mo). Forty-two RFNs were performed after the initial RFN. Forty-one of the 42 RFNs were available to follow-up (98%). Thirty-nine of the 41 RFNs were successful (95%). To date, 11 patients had a series of 2 RFNs performed, 7 had 3, 2 had 4, 1 had 6, and 1 had 7. Twenty-two patients had a second RFN, which was successful in 20 of the 21 available to follow-up (95%) but unsuccessful in 1 (5%). The mean duration of relief in these patients was 12.7 months (range, 3 to 30 mo) and the relief is continuing in 2 patients. Eleven patients had a third RFN, of which 10 (91%) were successful and 1 (9%) was unsuccessful. The mean duration of relief in 8 patients was 9.5 months (range, 3 to 16 mo), and the relief is continuing in the other 2. Four patients had a fourth RFN, which was successful in all 4. The mean duration of relief was 8.75 months (range, 4 to 12 mo). Two patients had a fifth RFN with both having a mean duration of relief of 9 months (11 and 7 mo, respectively). There were 2 patients with a sixth RFN, both were successful, 1 lasted 18 months and in the other relief is continuing. There was 1 patient with a successful seventh RFN, and relief is continuing. The frequency of success and durations of relief remained consistent after each subsequent RFN.
In a carefully selected group of patients with cervical facet joint pain who have been responsive to previous RFN, repeat RFNs are usually successful.
回顾性病历审查。
确定重复射频神经切断术（RFN）治疗颈椎小关节疼痛的成功率和缓解持续时间。
RFN是治疗颈椎小关节疼痛的一种有效但临时的方法。当疼痛复发时，通常会重复进行RFN，但重复RFN的效果尚未明确。
对连续的患者进行记录审查，这些患者最初的RFN成功，之后疼痛复发，然后进行了一次或多次重复RFN。将重复RFN的反应与最初RFN的成功率和缓解持续时间进行比较。成功的定义为目标疼痛缓解≥50%，且患者对先前的RFN足够满意，愿意再次进行RFN。
有14名女性和8名男性。平均年龄为47岁（范围34至66岁）。共进行了64次RFN。初次RFN后的平均缓解持续时间为12.5个月（范围3至25个月）。初次RFN后进行了42次RFN。42次RFN中有41次可供随访（98%）。41次RFN中有39次成功（95%）。迄今为止，11名患者进行了一系列2次RFN，7名患者进行了3次，2名患者进行了4次，1名患者进行了6次，1名患者进行了7次。22名患者进行了第二次RFN，21名可供随访的患者中有20次成功（95%），1次失败（5%）。这些患者的平均缓解持续时间为12.7个月（范围3至30个月），2名患者的缓解仍在持续。11名患者进行了第三次RFN，其中10次成功（91%），1次失败（9%）。8名患者的平均缓解持续时间为9.5个月（范围3至16个月），另外2名患者的缓解仍在持续。4名患者进行了第四次RFN，全部成功。平均缓解持续时间为8.75个月（范围4至12个月）。2名患者进行了第五次RFN，平均缓解持续时间均为9个月（分别为11个月和7个月）。有2名患者进行了第六次RFN，均成功，1次持续了18个月，另1名患者的缓解仍在持续。有1名患者第七次RFN成功，缓解仍在持续。每次后续RFN后的成功率和缓解持续时间保持一致。
在精心挑选的对先前RFN有反应的颈椎小关节疼痛患者组中，重复RFN通常是成功的。
