Department of Pain Management, Wuhan No.1 Hospital, Wuhan, 430022, Hubei Province, China.
J Orthop Surg Res. 2023 May 5;18(1):331. doi: 10.1186/s13018-023-03814-5.
Lumbar facet joint pain is a common disorder. The main symptom is chronic lumbar pain, which can reduce quality of life. Radiofrequency has often been used to treat lumbar facet joint pain. However, the effectiveness of this technique has been controversial. This study was conducted to compare the effectiveness of pulsed radiofrequency (PRF) and radiofrequency denervation (RD) for lumbar facet joint pain.
One hundred and forty-two patients with lumbar facet joint pain were allocated to two treatment groups: PRF group (N = 72) and RD group (N = 70). Patients enrolled in the study were assessed using a visual analogue scale (VAS), Roland-Morris questionnaire (RMQ), Oswestry disability index (ODI) and Short-Form 36 (SF-36) questionnaire before therapy, 3 months and 12 months later.
There were no significant differences in VAS, RMQ score, ODI score and SF-36 score at 3 months (p > 0.05). Significant differences in pain control were observed in both groups at 12 months (3.09 ± 1.72 vs. 2.37 ± 1.22, p = 0.006). There was a significant difference in RMQ score (11.58 ± 3.58 vs. 8.17 ± 2.34, p < 0.001) and ODI score (43.65 ± 11.01 vs. 35.42 ± 11.32, p < 0.001) at 12 months. The total SF-36 score was higher in the RD group than in the PRF group at 12 months (58.45 ± 6.97 vs. 69.36 ± 6.43, p < 0.001). In terms of complications, skin numbness occurred in three patients. Mild pain such as burning and pinking at the puncture site in two patients. One patient experienced a decrease in back muscle strength and back muscle fatigue. These complications disappeared in 3 weeks without any treatment. There were no serious adverse events in the PRF group.
Radiofrequency is an effective and safe treatment option for patients with lumbar facet joint pain. RD could provide good and lasting pain relief, with significant improvement in lumbar function and quality of life at long-term follow-up.
腰椎小关节疼痛是一种常见疾病。主要症状为慢性腰痛，可降低生活质量。射频治疗常用于治疗腰椎小关节疼痛。然而，该技术的疗效一直存在争议。本研究旨在比较脉冲射频（PRF）和射频神经切断术（RD）治疗腰椎小关节疼痛的疗效。
142 例腰椎小关节疼痛患者分为两组：PRF 组（n=72）和 RD 组（n=70）。患者在治疗前、治疗后 3 个月和 12 个月分别使用视觉模拟评分（VAS）、Roland-Morris 问卷（RMQ）、Oswestry 残疾指数（ODI）和简明健康状况量表（SF-36）进行评估。
治疗后 3 个月时，两组 VAS、RMQ 评分、ODI 评分和 SF-36 评分无显著差异（p>0.05）。两组在 12 个月时疼痛控制均有显著差异（3.09±1.72 vs. 2.37±1.22，p=0.006）。RMQ 评分（11.58±3.58 vs. 8.17±2.34，p<0.001）和 ODI 评分（43.65±11.01 vs. 35.42±11.32，p<0.001）在 12 个月时有显著差异。RD 组 SF-36 总分在 12 个月时高于 PRF 组（58.45±6.97 vs. 69.36±6.43，p<0.001）。在并发症方面，3 例患者出现皮肤麻木，2 例患者穿刺部位出现轻度疼痛，如烧灼感和潮红，1 例患者出现腰背肌无力和腰背肌疲劳。这些并发症在未经治疗的情况下 3 周内消失。PRF 组无严重不良事件。
射频治疗是治疗腰椎小关节疼痛的一种有效且安全的治疗选择。RD 可提供良好且持久的疼痛缓解，并在长期随访中显著改善腰椎功能和生活质量。
