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

 Jae Chul Koh  ;  Do Hyeong Kim  ;  Youn Woo Lee  ;  Jong Bum Choi  ;  Dong Hun Ha  ;  Ji Won An 
 KOREAN JOURNAL OF PAIN, Vol.30(4) : 296-303, 2017 
Journal Title
Issue Date
Ablation technique ; Facet joint ; Fasciculation ; Innervation ; Lower back pain ; Prognosis ; Radiofrequency catheter ablation
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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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koh, Jae Chul(고재철)
Kim, Do Hyeong(김도형) ORCID logo https://orcid.org/0000-0003-2018-8090
An, Ji Won(안지원)
Lee, Youn Woo(이윤우)
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