Two-Needle Technique for Lumbar Radiofrequency Medial Branch Denervation: A Technical Note

Area of Science:

• Interventional Pain Management
• Neurosurgery
• Orthopedics

Background:

• Facet joint pain affects many patients, with radiofrequency ablation (RFA) offering relief in 60% for 6-12 months.
• A significant portion of patients experience limited or short-term pain relief from RFA.
• Current RFA techniques may fail due to inadequate nerve coagulation or reinnervation.

Purpose of the Study:

• To describe a modified lumbar medial branch radiofrequency (RF) denervation technique.
• The modification aims to increase the size of the ablation lesion.

Main Methods:

• A technical report detailing a novel two-needle approach for lumbar RF medial branch denervation.
• Utilizes dual 10-mm active tip RF cannulas placed 6 mm apart.
• Cannulas contact the superior articular process (SAP) to cover the medial branch nerve course.

Main Results:

• The two-needle technique creates an estimated lesion of 11.0 mm width and 11.6 mm length.
• This larger lesion size ensures comprehensive coverage and treatment of the medial branch nerves adjacent to the SAP.

Conclusions:

• The two-needle approach to lumbar RF medial branch denervation shows promise for increasing treatment success.
• This technique may offer a cost- and time-efficient method for coagulating a larger tissue volume.
• Further studies are needed to evaluate the long-term clinical safety and efficacy of this approach.