医学
面(心理学)
腰椎
皮质类固醇
随机对照试验
小关节
射频消融术
烧蚀
物理疗法
外科
麻醉
内科学
心理学
社会心理学
人格
五大性格特征
作者
Zachary L. McCormick,Aaron Conger,Richard Kendall,Graham Wagner,A. Michael Henrie,Madelaine Littell,Beau P. Sperry,Russel Petersen,Amanda Cooper,Masaru Teramoto,Taylor Burnham
出处
期刊:Pain Medicine
[Oxford University Press]
日期:2023-08-14
卷期号:24 (12): 1318-1331
被引量:2
摘要
Abstract Background Lumbar medial branch radiofrequency ablation (LRFA) and intraarticular facet steroid injections (FJI) are commonly performed for recalcitrant facet joint-mediated pain. However, no study has compared clinical outcomes of the two treatments in patients selected using dual medial branch blocks (MBBs) with an 80% relief threshold. Objective Compare the effectiveness of cooled LRFA (C-LRFA) to FIJ as assessed by pain and functional improvements. Design Prospective randomized comparative trial. Methods Patients with dual MBB-confirmed facet joint-mediated pain were randomized to receive C-LRFA or FIJ. Outcomes were assessed at 1, 3, 6, and 12 months. The primary outcome was ≥50% improvement in numerical pain rating scale (NPRS) score at 3 months. Secondary outcomes included ≥30% Oswestry Disability Index (ODI) improvement and Patient Global Impression of Chance (PGIC) ≥6 points, among others. Data were analyzed using contingency tables and mixed-effects logistic regression models. Results Of 1128 patients screened, 32 met eligibility criteria, were randomized, and received their allocated study treatment. In total, 20 (62.5%) and 12 (37.5%) participants received C-LRFA and FIJ, respectively. In the C-LRFA group, 70% (95% CI 48–85), 55% (95% CI 34–74), and 45% (95% CI 26–66) of participants met the NPRS responder definition, compared to 25% (95%CI 9–53), 25% (95% CI 9–53), and 17% (95% CI 5–45) in the FJI group at 3, 6, and 12 months, respectively (P = .014 at 3 months). The PGIC responder proportion was higher in the C-LRFA compared to FJI group at 3 and 6 months (P < .05). Conclusions C-LRFA demonstrated superior success rates compared to FJI across pain and functional outcome domains. Trial registration details ClinicalTrials.gov (NCT03614793); August 3, 2018.
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