Sen Hasan, Cooper Amanda, Stephens Andrew, Martin Brook, Burnham Robert S, Conger Aaron, McCormick Zachary L, Burnham Taylor R
Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT, United States.
Department of Physical Medicine and Rehabilitation, University of Rochester Medical Center, Rochester, NY, United States.
Interv Pain Med. 2025 Mar 1;4(1):100563. doi: 10.1016/j.inpm.2025.100563. eCollection 2025 Mar.
Thoracic medial branch radiofrequency neurotomy (TMBRFN) is used to treat chronic thoracic facet joint pain, but research on its technique and effectiveness is still needed. The current International Pain and Spine Intervention Society Practice Guidelines do not describe a technique for TMBRFN.
Evaluate the effectiveness of TMBRFN in patients with thoracic facet joint pain.
Single-arm, retrospective cohort study of consecutive patients from two Canadian musculoskeletal pain management clinics who underwent first-time TMBRFN between 2016 and 2022. The primary outcome was the proportion of patients with ≥50 % reduction in numerical rating scale (NRS) pain score at 3-months post-procedure. Secondary outcomes included the proportion of patients who achieved a ≥17-point reduction on the Pain Disability Quality-Of-Life Questionnaire-Spine (PDQQ-S) at 3-months, as well as mean patient-reported percentage pain relief and duration of relief after a successful index TMBRFN in individuals who reported a return of their index symptoms.
18 consecutive patients (50.0 % male; mean age 60.9 ± 15.3 years; mean BMI 30.3 ± 6.9 kg/m) were analyzed. At 3 months post-procedure, 10 patients (55.6 % [95%CI 33.7-75.4]) reported ≥50 % NRS pain reduction and 9 (50.0 % [95%CI 29.0-71.0]) reported ≥17-point PDQQ-S reduction. Of the 10 patients with successful treatment responses, 4 had a return of symptoms after an average of 9.3 ± 2.2 months with a reported retrospective mean percentage pain relief of 70.0 ± 34.6 %.
Within this cohort, approximately 60 % of patients experienced improvement in pain and disability at 3 months following TMBRFN. Among patients whose index symptoms returned after successful treatment, the average reported pain relief was 70 % for close to 9 months. Larger, prospective studies with long-term outcomes are needed to better elucidate the safety and effectiveness of TMBRFN.
胸段内侧支射频神经切断术（TMBRFN）用于治疗慢性胸段小关节疼痛，但仍需对其技术和有效性进行研究。当前的国际疼痛与脊柱介入协会实践指南未描述TMBRFN的技术。
评估TMBRFN对胸段小关节疼痛患者的有效性。
对来自加拿大两家肌肉骨骼疼痛管理诊所的连续患者进行单臂回顾性队列研究，这些患者在2016年至2022年间首次接受TMBRFN。主要结局是术后3个月时数字评分量表（NRS）疼痛评分降低≥50% 的患者比例。次要结局包括术后3个月时在疼痛残疾生活质量问卷 - 脊柱版（PDQQ - S）上降低≥17分的患者比例，以及在成功进行首次TMBRFN后报告指标症状复发的个体中，患者报告的平均疼痛缓解百分比和缓解持续时间。
分析了18例连续患者（50.0% 为男性；平均年龄60.9±15.3岁；平均BMI 30.3±6.9kg/m）。术后3个月时，10例患者（55.6% [95%CI 33.7 - 75.4]）报告NRS疼痛降低≥50%，9例（50.0% [95%CI 29.0 - 71.0]）报告PDQQ - S降低≥17分。在10例治疗反应成功的患者中，4例在平均9.3±2.2个月后症状复发，报告的回顾性平均疼痛缓解百分比为70.0±34.6%。
在该队列中，约60% 的患者在TMBRFN术后3个月时疼痛和残疾状况有所改善。在成功治疗后指标症状复发的患者中，报告的平均疼痛缓解率为70%，持续近9个月。需要开展更大规模的、具有长期结局的前瞻性研究，以更好地阐明TMBRFN的安全性和有效性。
