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KMID : 1040020120030010054
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International Journal of Pain
2012 Volume.3 No. 1 p.54 ~ p.59
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Effect of Lumbar Radiofrequency Neurotomy on Multifidus Atrophy
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Park Chan-Hong
Lee Sang-Ho
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Abstract
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Bacground: A medial branch radiofrequency neurotomy (RFN) for lumbar zygapophyseal-mediated pain dose cause initial denervation, and found that diffuse discernable segmental atrophy of multifidus muscle. The aim of our study was to evaluate the multifidus muscle morphologic changes in multifidus muscle after bilateral radiofrequency neurotomy (RFN) and to determine the relationship between the post-treatment multifidus muscle size and the clinical response to RFN.
Methods: All 14 patients underwent computed tomography (CT). The cross-sectional area of the multifidus muscle was measured on the transverse angled sections. All RFN procedures were performed in the CT room and the multifidus muscle cross sectional area (MCSA) was measured at pre-treatment and 4 weeks later with CT. Outcome measures were obtained using the 5-point patient’s satisfaction scale at 4 weeks. To evaluate the correlation between pain reduction and multifidus muscle size, we divided the patients into two groups according to treatment responses.
Results: Following RFN, no significant changes in MCSA were observed. Improvement of pain (including reports of slightly improved, much improved, and no pain) was reported by 64.3% of patients (9/14) at 4 weeks. MCSA of the two patient groups (those who claimed improvement and those who did not) were similar, showing no significant correlation with level of pain relief.
Conclusions: At 4 weeks after bilateral lumbar medial branch RFN, atrophy of the multifidus muscle was not evident, and post-treatment MCSA did not affect to outcomes.
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KEYWORD
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computed tomography, facet joint low back pain, multifidus muscle, muscle atrophy
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