Effectiveness of Repeat Radiofrequency Nerve Ablation for Spine Joint Pain: A Case Series

Casey Murphy, MD, FAAPMR, DAAPM

Background: Radiofrequency Nerve Ablation (RFA) has been used to treat spine joint pain for more than two decades. There have been no recent studies reviewing efficacy and side effects of multiple repeat RFA.1-3

Objectives: To determine the success rate, duration of relief, and side effects of repeat RFA for spine joint pain. RFA is also called radiofrequency neurotomy and dorsal rhizotomy.

Methods: Veterans Affairs Medical Center of New Orleans record review and phone call of patients who had an initial successful RFA, recurrence of pain, and then at least 7 repeat RFAs was done. Responses of repeat RFA were compared with initial RFA for success rates and duration of relief. Success was defined as >50% relief of targeted pain, and the patient sufficiently satisfied with prior RFA to have RFA repeated. Complications and side effects were also measured.

Results: There were 5 patients included. The age range was 41 to 75 years old with the mean being 61. It included 4 men and 1 woman. 4 had bilateral L3,4,5 medial branch RFA and 1 had bilateral sacroiliac joint RFA. Two had 12 RFAs, 1 had 11 RFAs, 1 had 9 RFAs, and 1 had 7 RFAs. The time course was from 2012 to 2023 with the majority having repeat procedures annually. All patients had successful repeat RFA. The average length of time of benefit was 11 months which did not decrease on repeat RFA. There were no serious neurological complications, hematomas, or infections. Some of the patients reported post-procedural soreness which resolved after a few days.

Conclusion: Repeat RFA is a safe and effective treatment for chronic spine joint pain.

1. Jerome Schofferman, MD, and Garrett Kine, MD. Effectiveness of Repeated Radiofrequency Neurotomy for Lumbar Facet Pain. SPINE Volume 29, Number 21, pp 2471–2473, 2004.
2. Daniel S. Husted, MD, Derek Orton, MD, Jerome Schofferman, MD, and Garrett Kine, MD. Effectiveness of Repeated Radiofrequency Neurotomy for Cervical Facet Joint Pain. Journal Spinal Disorders Tech, Volume 21, Number 6, 2008.
3. Jung Hee Son, M.D., Sang Dae Kim, M.D., Se Hoon Kim, M.D., Dong Jun Lim, M.D., Jung Yul Park, M.D., Ph.D. The Efficacy of Repeated Radiofrequency Medial Branch Neurotomy for Lumbar Facet Syndrome. Journal Korean Neurosurgery Society, 48 : 240-243, 2010.