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KMID : 0363120170300040296
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Korean Journal of Pain
2017 Volume.30 No. 4 p.296 ~ p.303
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Relationship between paravertebral muscle twitching and long-term effects of radiofrequency medial branch neurotomy
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Koh Jae-Chul
Kim Do-Hyeong
Lee Youn-Woo
Choi Jong-Bum
Ha Dong-Hun
An Ji-Won
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Abstract
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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.
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KEYWORD
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Ablation technique, Facet joint, Fasciculation, Innervation, Lower back pain, Prognosis, Radio-frequency catheter ablation
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