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Relationship between paravertebral muscle twitching and long-term effects of radiofrequency medial branch neurotomy

Authors
 Jae Chul Koh  ;  Do Hyeong Kim  ;  Youn Woo Lee  ;  Jong Bum Choi  ;  Dong Hun Ha  ;  Ji Won An 
Citation
 Korean Journal of Pain (대한통증학회지), Vol.30(4) : 296-303, 2017 
Journal Title
 Korean Journal of Pain (대한통증학회지) 
ISSN
 2005-9159 
Issue Date
2017
Keywords
Ablation technique ; Facet joint ; Fasciculation ; Innervation ; Lower back pain ; Prognosis ; Radiofrequency catheter ablation
Abstract
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.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/160914
DOI
10.3344/kjp.2017.30.4.296
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실)
Yonsei Authors
고재철(Koh, Jae Chul) ; 김도형(Kim, Do Hyeong) ; 안지원(An, Ji Won) ; 이윤우(Lee, Youn Woo)
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