The effectiveness of cervical medial branch radiofrequency ablation using a three-tined electrode: A real-world...

Cervical medial branch radiofrequency ablation (CMBRFA) using conventional electrodes is a proven treatment for chronic cervical zygapophysial (facet) joint pain. More recently, multi-tined RFA technology has been adopted in clinical practice, warranting evaluation of treatment outcomes.

Evaluate the effectiveness of CMBRFA using a three-tined RFA electrode for the treatment of cervical facet joint pain in a real-world cohort.

In this cross-sectional cohort study, electronic medical records of patients who underwent CMBRFA utilizing a three-tined RFA electrode at a single academic medical center between 2022 and 2024 were reviewed. Outcomes were collected at ≥6 months post-CMBRFA via standardized telephone survey, querying numerical rating scale (NRS) pain scores, patient global impression of change (PGIC) scores, and opioid use. The primary outcome was the proportion reporting ≥50 % NRS reduction. Secondary outcomes included ≥2-point NRS reduction, PGIC scores ≥6 (indicating at least "much improved"), and pre-versus post-CMBRFA opioid use. Potential predictors of treatment success were evaluated with multivariate Poisson regression analysis.

66 patients were included. At mean follow-up of 16.3 ± 7.0 months, 51.5 % (95 %CI: 39.7-63.2) reported ≥50 % NRS reduction, 77.3 % (95 %CI: 65.8-85.7) experienced ≥2-point NRS reduction, and 63.6 % (95 %CI: 51.6-74.2) had PGIC ≥6. Opioid use was decreased significantly by 15.2 % (95 %CI: 5.0-25.3). Follow-up time and repeat CMBRFA were significantly associated with outcomes for PGIC.

In this real-world cohort, we observed clinically meaningful improvements in neck pain (defined as ≥50 % NRS reduction from baseline) in 51.5 % of participants at an average of approximately 16 months after treatment with CMBRFA using a three-tined electrode.