Outcome of Combined Radiofrequency Medial Branch Rhizotomy and Steroid Nerve Block in Lumbar Facet Arthropathy: A Randomized Controlled Clinical Trial

Abstract Background: The facet joints are synovial joints that may be pain generators in patients with chronic low back pain. This is now well known as facet syndrome. The aim of this study is to provideour experience about efficacy, safety and technique of combined treatment with medial branch radiof-requency rhizotomy and steroid block for lumbar facet syn-drome. Although radiofrequency ablation is frequently used, there is no high quality evidence for its efficacy. Aim of Study: The aim of this study is to present our experience using combined treatment with medial branch radiofrequency neurotomy and steroid block in the management of chronic low back pain due to facet arthropathy. Technique, safety, and efficacy will be reported. Patients and Methods: Thirty-eight patientswere managed by combined treatment with medial branch radiofrequency rhizotomy and steroid block (the intervention group). The VAS (Visual analog scale) before the intervention (pre-VAS), one week after the intervention (immediate post VAS), at one month (post VAS 1), at three months (post VAS 2) and at six months after the intervention (post VAS 3) were compared at each time point with the control group (38 patients). The control group received the best medical treatment and a regular exercise program for six months. Diagnostic block was done for all cases. Results: There were significant differences between both groups concerning immediate post VAS, post VAS 1, post VAS 2 and post VAS 3 as the p-values were <0.01 in all relationships. No adverse events of infection, neurologic injury, or any other complication were reported. Conclusion: Participants with lumbar facet syndrome who received combined treatment with medial branch radiof-requency rhizotomy and steroid block experienced significant clinical improvement compared to those who received con-servative treatment.