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

Lumbar medial branch radiofrequency ablation (LMBRFA) is an established treatment for chronic lumbar zygapophysial (facet) joint pain. Three-tined radiofrequency technology may simplify the procedure compared to conventional techniques, but long-term outcomes require further investigation.

To assess long-term outcomes of three-tined LMBRFA utilizing a perpendicular approach.

This study reviewed electronic medical records of patients who underwent three-tined LMBRFA from 2022 to 2024. Clinical outcomes were assessed at ≥6 months post-procedure via standardized telephone survey, including numerical rating scale (NRS) pain scores, patient global impression of change (PGIC), and opioid utilization. The primary outcome was the proportion of patients achieving ≥50 % NRS pain reduction. Secondary outcomes included PGIC scores ≥6 ("much improved" or better) and changes in opioid use. Poisson regression evaluated select predictors of treatment response.

Outcomes were collected from 71 patients at a mean follow-up of 12.5 ± 2.4 months. The primary outcome was achieved by 43.7 % (95 %CI: 32.8-55.2) of patients at mean follow-up, with higher success rates at 6-12 months (51.7 %) compared to 12-18 months (38.1 %; p = 0.332). At average follow-up, 53.5 % (95 %CI: 42.0-64.6) of patients reported PGIC scores ≥6, while opioid analgesic use was significantly reduced from baseline (75 % opioid cessation rate among baseline opioid users). Advanced age, repeat LMBRFA, and shorter follow-up were associated with a greater likelihood of treatment success.

In this cohort, approximately half of patients selected for three-tined perpendicular LMBRFA by guideline-concordant diagnostic blocks went on to experience ≥50 % pain relief for up to 12 months. Opioid analgesic use was significantly reduced compared to baseline.