Radiofrequency Ablation for the Treatment of Chronic Lumbar Facets Arthropathy; Bipolar Radiofrequency at Two Points Versus Monopolar Radiofrequency at One Point - A Randomized Control Trial

Volume 1 - Issue 4

Wael M Abdelkhalek₁, Mohamed M Hashim₂, Adel M Shaaban₃ and Dhafir A Alkhudairi₄*

Received: May 30, 2019;   Published:June 07, 2019

DOI: 10.32474/GJAPM.2018.01.000118

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Abstract

Background: Radiofrequency (RF) ablation has reported variable results in the treatment of facet joint pain; therefore, more robust evidence for RF ablation for the management of facet joint pain is needed to establish the optimum. This study compares the effectiveness of two different techniques of applying RF ablation, monopolar vs bipolar, to the medial branch of the dorsal nerve.

Methods: After diagnostic facet joint injection with lidocaine 2%, patients who demonstrated an improvement in Visual Analogue Scale (VAS) score of more than 50%, were divided into two groups with a total 50 subjects (25patients in each group). Group 1 would receive monopolar RF at one point, group 2 would receive bipolar RF at 2 points. The patients in each group were evaluated in 2 weeks, 1 month, 3 months and 6 months’ intervals, using the VAS score. Overall patient satisfaction was evaluated by the patient satisfaction score.

Results: There was no significant difference in VAS score between the groups (‘between subject test’ p = 0.224). The median initial pain score was 8 [8-10] and was comparable between group one and group two (9 [8-10] and 8 [8-10], respectively; p = 0.338). The patient satisfaction score was comparable between group one, and two (6 [5-7] and 7 [5-8], respectively; p = 0.170).

Conclusions: The use of bipolar technique in comparison to Monopolar technique for RF neurotomy of the medial branch of the dorsal nerve did not add more benefits to the patients in decreasing pain scores at different timings.

Keywords: Back Pain; Facet Joint Arthropathy; Medial Branch Radiofrequency; Radio Frequency Ablation; Treatment; Zygapophyseal Joint

Abstract| Introduction| Materials and Methods| Statistical Analysis| Results| Discussion| Conclusion| References|