Lumbar Medial Branch Radiofrequency Neurotomy in New Zealand

Abstract

This study aims to determine the effectiveness of lumbar medial branch radiofrequency neurotomy (RFN) performed by two practitioners trained according to rigorous guidelines. Prospective, outcome study of consecutive patients with chronic back pain treated in a community setting. A total of 106 patients, selected on the basis of complete relief of pain following controlled, diagnostic, medial branch blocks, were treated with RFN according to the guidelines of the International Spine Intervention Society. Successful outcome was defined as complete relief of pain for at least 6 months, with complete restoration of activities of daily living, no need for any further health care, and return to work. Patients who failed to meet any of these criteria were deemed to have failed treatment. In the two practices, 58% and 53% of patients achieved a successful outcome. Relief lasted 15 months from the first RFN and 13 months for repeat treatments. Allowing for repeat treatment, patients maintained relief for a median duration of 17-33 months, with some 70% still having relief at follow-up. Lumbar RFN can be very effective when performed in a rigorous manner in appropriately selected patients. Chronic back pain, mediated by the lumbar medial branches, can be stopped and patients fully restored to normal living, if treated with RFN.