Radiofrequency lumbar facet denervation: A comparative study of the reproducibility of lesion size after 2 current radiofrequency techniques
Date
2004
Authors
Buijs, E.
van Wijk, R.
Geurts, J.
Weeseman, R.
Stolker, R.
Groen, G.
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Journal article
Citation
Regional Anesthesia and Pain Medicine, 2004; 29(5):400-407
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Evert J. Buijs, Roelof M.A.W. van Wijk, Jos W.M. Geurts, Rolf R. Weeseman, Robert J. Stolker and Gerbrand G. Groen
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Abstract
<h4>Background and objectives</h4>Radiofrequency facet denervation procedures are widely used for the treatment of chronic low-back pain. Currently, both temperature-controlled and voltage-controlled techniques are used. In this combined in vivo and in vitro study, the electrophysiologic consequences and the effects on lesion size of these techniques were determined.<h4>Methods</h4>Thirty-three patients were randomly assigned to receive a lumbar radiofrequency facet denervation by using either temperature-controlled (80 degrees C, 60 seconds) or voltage-controlled (20 V, 60 s) mode. Electrophysiologic parameters in both groups during radiofrequency lesioning were registered. Observed differences between electrodes were quantified and interpreted, using lesion-size data from egg-white experiments.<h4>Results</h4>Seventeen patients in the temperature group were treated with a total of 55 radiofrequency lesions, all considered technically adequate. In the voltage-controlled group, 16 patients received 63 lesions. Of these, 44 (69.8%) procedures were found to be technically inadequate. Voltage-controlled radiofrequency lesioning resulted in uncontrollable fluctuations of temperature, with resultant uncontrollable variations in lesion size. Temperature-controlled mode created reproducible lesion sizes.<h4>Conclusions</h4>There is no consistent relation between voltage and the temperature obtained during radiofrequency lumbar facet denervation. Temperature-controlled radiofrequency lesioning is preferred to create reproducible lesion sizes.
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Copyright © 2004 American Society of Regional Anesthesia and Pain Medicine Published by Elsevier Inc.