The Efficacy of Radiofrequency Ablation for Pain Management in Patients with Pre-Existing Hardware at the Site of Ablation.

INTRODUCTION: Radiofrequency ablation (RFA) is an interventional procedure that provides pain relief by using thermal energy to disrupt peripheral nerves carrying nociceptive signals back to the central nervous system. In the past, having implantable hardware at the planned site of RFA was considered to confer increased risk of adverse outcomes given the theoretical risk of heating of the hardware components. The present study examines patient outcomes to determine whether the efficacy of RFA was affected by the presence of implanted hardware directly at the site. METHODS: This was a retrospective case-control study that included 52 patients who received RFA procedures in the presence of hardware at the site of RFA and a control group of 170 patients who received RFA procedures in the absence of hardware. Data were collected from electronic medical records entered into an Excel sheet and then analyzed using SPSS version 22. Outcomes tested included post procedure pain scores, percent, and duration of improvement, if any. RESULTS: We found no statistically significant difference in measured outcomes between either group. CONCLUSIONS: This study provides some evidence in support of the theory that RFA procedures performed on patients with pre-existing hardware have similar efficacy when compared to their hardware-free counterparts.

Is a One Prognostic Block Sufficient to Proceed with Radiofrequency Ablation? A Single Center Experience.

PURPOSE OF REVIEW: We performed this study and associated review to examine whether a one prognostic block is sufficient to proceed with radiofrequency ablation. RECENT FINDINGS: To perform one or two prognostic blocks before performing radiofrequency ablation is a very controversial issue. The practice is inconsistent and insurance companies even do not follow same regulations. We found in our research that majority of patients who receive a successful first prognostic block also receive a successful second prognostic block. We think one prognostic block can be sufficient to move forward with radiofrequency ablation.

The Long-Term Efficacy of Radiofrequency Ablation With and Without Steroid Injection.

Background: Radiofrequency ablation (RFA) has been proven to be an effective option for treating chronic low back pain. In addition to RFA as a treatment modality, the administration of concomitantly to minimize the effect of hyperalgesia is common practice. However, there is insufficient evidence about the long-term outcomes of their use. Methods: This was a retrospective study that examined 239 patients who received spine, knee joint, and sacroiliac joint RFA between June 2014 and June 2018. Pre- and post-procedure pain scores, percent improvements, and duration of relief were included in our review. Subjects: This study included 239 patients of which 191 patients received steroids with their RFA. Results: These 191 patients experienced an average improvement of 48.48% relief for an average of 137.52 days. Forty-eight patients did not receive steroids with RFA and had an average improvement of 46.36% for an average of 126.10 days. The statistical analysis revealed there was no significant difference between the two groups for percent improvement (p = 0.71) and duration of relief (p = 0.67). Conclusions: Patients who received steroids with RFA compared to RFA alone did not differ significantly in percent improvement in pain and duration of relief.