一种用于小关节去神经支配的新型方法：用于腰椎小关节综合征的冷循环射频消融术。病例系列

A Novel Modality for Facet Joint Denervation: Cooled Radiofrequency Ablation for Lumbar Facet Syndrome. A Case Series.

作者信息

McCormick Zachary L, Walker Jeremy, Marshall Benjamin, McCarthy Robert, Walega David R

机构信息

The Rehabilitation Institute of Chicago/Northwestern University Feinberg School of Medicine, Department of Physical Medicine and Rehabilitation, USA.

Northwestern University Feinberg School of Medicine, Department of Anesthesiology, USA.

出版信息

Phys Med Rehabil Int. 2014;1(5):5.

PMID:25866845

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4389681/

Abstract

BACKGROUND

While cooled radiofrequency ablation (C-RFA) appears to be a promising technology for joint denervation, outcomes of this technique for the treatment of lumbar facet syndrome have not been described. We report clinical outcomes in a case series of patients treated with C-RFA for lumbar facet syndrome.

METHODS

Consecutive patients aged 18-60 years diagnosed with lumbar facet syndrome, confirmed by ≥75% symptom relief with at least one set of diagnostic medial branch nerve blocks, who underwent C-RFA between January 2007 and December 2013 in an urban academic pain center were included. The respective proportions of participants who reported ≥50% improvement in pain and in function were calculated. Change in median NRS score, daily morphine equivalent consumption (DME), and medication quantification scale III (MQS III) score were measured.

RESULTS

Twelve patients underwent C-RFA; three were lost to follow-up. The median and 25%-75% interquartile range (IQR) for age was 44 years (35, 54). The median duration of follow-up was 34 months, IQR (21, 55). The percentage and 95% confidence interval (CI) of patients who reported ≥50% improvement in pain was 33% CI (12%, 64%) and in function was 78%, CI (41%, 96%). There was no significant change in DME or MSQ III score. Approximately 50% of patients sought additional healthcare by long-term follow-up. No complications were reported.

CONCLUSIONS

This case series suggests that C-RFA may improve function and to a lesser degree pain at long-term follow-up. A randomized, controlled trial is warranted.

摘要

背景

虽然冷循环射频消融术（C-RFA）似乎是一种有前景的关节去神经技术，但该技术治疗腰椎小关节综合征的结果尚未见报道。我们报告了一组接受C-RFA治疗腰椎小关节综合征患者的临床结果。

方法

纳入2007年1月至2013年12月在一家城市学术疼痛中心接受C-RFA治疗的连续患者，年龄在18 - 60岁之间，经诊断为腰椎小关节综合征，至少一组诊断性内侧支神经阻滞使症状缓解≥75%。计算报告疼痛和功能改善≥50%的参与者各自的比例。测量NRS评分中位数、每日吗啡当量消耗量（DME）和药物量化量表III（MQS III）评分的变化。

结果

12例患者接受了C-RFA治疗；3例失访。年龄的中位数和25%-75%四分位数间距（IQR）为44岁（35, 54）。随访时间中位数为34个月，IQR（21, 55）。报告疼痛改善≥50%的患者百分比及95%置信区间（CI）为33% CI（12%, 64%），功能改善≥50%的患者百分比及95% CI为78%，CI（41%, 96%）。DME或MSQ III评分无显著变化。约50%的患者在长期随访中寻求了额外的医疗护理。未报告并发症。