Relationship between paravertebral muscle twitching and long-term effects of radiofrequency medial branch neurotomy.
10.3344/kjp.2017.30.4.296
- Author:
Jae Chul KOH
1
;
Do Hyeong KIM
;
Youn Woo LEE
;
Jong Bum CHOI
;
Dong Hun HA
;
Ji Won AN
Author Information
1. Department of Anesthesiology and Pain Medicine, Gangnam Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. anzi1md@naver.com
- Publication Type:Original Article
- Keywords:
Ablation technique;
Facet joint;
Fasciculation;
Innervation;
Lower back pain;
Prognosis;
Radiofrequency catheter ablation
- MeSH:
Ablation Techniques;
Catheter Ablation;
Fasciculation;
Humans;
Low Back Pain;
Needles;
Prognosis;
Zygapophyseal Joint
- From:The Korean Journal of Pain
2017;30(4):296-303
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: To achieve a prolonged therapeutic effect in patients with lumbar facet joint syndrome, radiofrequency medial branch neurotomy (RF-MB) is commonly performed. The purpose of this study was to evaluate the prognostic value of paravertebral muscle twitching when performing RF-MB in patients with lumbar facet joint syndrome. METHODS: We collected and analyzed data from 68 patients with confirmed facet joint syndrome. Sensory stimulation was performed at 50 Hz with a 0.5 V cut-off value. Patients were divided into 3 groups according to the twitching of the paravertebral muscle during 2 Hz motor stimulation: ‘Complete’, when twitching was observed at all needles; ‘Partial’, when twitching was present at 1 or 2 needles; and ‘None’, when no twitching was observed. The relationship between the long-term effects of RF-MB and paravertebral muscle twitching was analyzed. RESULTS: The mean effect duration of RF-MB was 4.6, 5.8, and 7.0 months in the None, Partial, and Complete groups, respectively (P = 0.47). Although the mean effect duration of RF-MB did not increase significantly in proportion to the paravertebral muscle twitching, the Complete group had prolonged effect duration (> 6 months) than the None group in subgroup analysis. (P = 0.03). CONCLUSIONS: Paravertebral muscle twitching while performing lumbar RF-MB may be a reliable predictor of long-term efficacy when sensory provocation under 0.5 V is achieved. However, further investigation may be necessary for clarifying its clinical significance.
