Factors determining the success of radiofrequency denervation in lumbar facet joint pain: a prospective study
Streitberger, Konrad ; Müller, Tina ; Eichenberger, Urs ; Trelle, Sven ; Curatolo, Michele
In: European Spine Journal, 2011, vol. 20, no. 12, p. 2160-2165
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- Background and aims: Radiofrequency denervation (RF) of the lumbar facet joints has been shown to be effective in well-selected patients. However, long-term success varies between studies. We evaluated the influence of selected psychosocial and constitutional factors on the outcome of RF, expressed as the duration of pain relief. Methods: This prospective observational study included 44 patients who received RF denervations at the University Hospital of Berne. Success was defined as at least 50% pain reduction 7-21days, 6months and 1year after RF therapy. The Cox-regression analysis was performed to evaluate the influence of the following factors on the duration of success: age, sex, depression, work inability and previous surgery. Results: Complete follow-up was available for 41 patients. The success rate 7-21days after the denervation was 76%. It decreased to 32% at 6months and to 22% at 1year. The median success duration was 17weeks (95% CI 10-26). The Cox-regression analysis showed a significant shorter duration of success for patients with depression (hazard ratio [HR] 2.97, 95% CI 1.32-6.65), previous surgery (HR 2.39, 95% CI 1.10-5.21) and number of treated joints (HR 1.95 for each increase in the number of joints, 95% CI 1.14-3.33). In bivariate analyses, only depression was kept to be significant. Conclusions: Depression seems to be related with a short duration of success. Based on these findings, a comprehensive study is warranted to evaluate whether psychosocial factors have to be considered when recruiting patients for radiofrequency denervation