1455 - Long-Term Outcomes After Lumbar Radiofrequency Ablation

Axial low back pain originating from the zygapophyseal joints can be treated with radiofrequency ablation (RFA) of the medial branches of the dorsal rami. A recent systematic review found that 49% of patients who underwent RFA for low back pain had at least 50% pain relief, however several included studies used suboptimal RFA technique (Schneider, et al., 2020, Pain Medicine). The purpose of this study was to examine the long-term effectiveness of lumbar RFA for patients that were treated using techniques described in the IPSIS (International Pain and Spine Intervention Society) guidelines.

Design:

This retrospective cohort study evaluates patient outcomes after lumbar RFA performed between Nov. 2017 and Jan. 2025 by two PM&R physicians who are IPSIS instructors at the same institution. Data collection was comprised of a chart review to gather patient demographics, procedure details, any repeated procedures and outcomes described at clinic visits.

Results:

131 patients had lumbar RFA performed. Average duration of pain prior to RFA was 59 months and average NRS was 6/10. 25 and 65 patients were lost to follow-up at 1 and 6 months, respectively. 11% of patients had no relief after RFA at 1 month follow-up. Patients with relief at one month (n = 91) reported 75% relief on average. Of patients who followed up at 6 months (n = 66), 71% had continued relief, 77% relief on average. Of patients who had RFA repeated (n = 24), average time before repeat was 15 months.

Conclusions:

Patients who receive lumbar RFA performed using IPSIS technique are more likely to experience pain relief, and achieve a greater amount and duration of relief, when compared to studies that do not specify adherence to IPSIS technique. Future work is planned which will collect electronic surveys to capture long-term outcomes from all patients, including those lost to follow-up.