Cooled Radiofrequency Ablation of Thoracic Medial Branches for the Treatment of Chronic Thoracic Pain.

Chronic thoracic pain is commonly caused by thoracic facet dysfunction, intercostal neuralgia, surgery, or thoracic pain secondary to cancer and is present in approximately 15% of the population. Conventional treatments, including pharmacotherapy and transcutaneous electrical nerve stimulation, are often ineffective and are often associated with poorly tolerated adverse effects. Cooled radiofrequency ablation (c-RFA) is a minimally invasive procedure that uses radiofrequency energy delivered through a probe to lesion the targeted nerve and provide significant and lasting relief. : This study was a retrospective analysis of data extracted from UW-Health Electronic Medical Health records from October 2015 through June 2024. Patient data were collected, including diagnosis, pre-operative pain score, post-operative pain score, duration of relief, age, sex, and BMI. A two-tailed paired -test was used to analyze the pre-operative and post-operative pain scores. A -value < 0.05 was considered significant. : A total of 111 thoracic c-RFA procedures were reviewed; 43 were excluded due to absent pre-operative or post-operative pain scores in medical records. A total of 68 procedures were included in the analysis, comprising 55 patients: 25 females and 30 males with an average age of 51.31 ± 18.22 years and a BMI of 29.79 ± 6.48 kg/m. Improvement in pain scores was reported in 77.94% (n = 53), 16.18% (n = 11) reported no change, and 5.88% (n = 4) reported worsening pain. Patients reported an average pre-operative pain score of 5.98 (M = 5.98, SD = 1.91) and an average post-operative pain score of 3.06 (M = 3.06, SD = 2.52); this achieved significance ( < 0.0001). Of the 77.94% (n = 53) charts that noted improvement, there is an average of 62.83 ± 28.48% reduction from their pre-operative pain scores. The average duration of relief lasted 11.85 ± 13.42 months. : This study supports the efficacy and safety of c-RFA as a minimally invasive therapy for chronic thoracic pain refractory to conservative measures.