Efficacy of the Multimodal and Multilevel Radiofrequency Nerve Ablation for the Management of Low Back Pain Chronic

Abstract

Background: Low back pain is currently an important health problem that represents a significant socioeconomic cost in Western societies and is associated with higher rates of disability than any other disorder. Although most cases are treated successfully at the first level of care, it is estimated that around 15% become chronic, resisting conservative treatment. Aims: to know the analgesic effects by means of the "visual analog scale" and functional effects (oswestry) in patients submitted to radiofrequency, the aim is to know the incidence of low back pain secondary to facet syndrome in the traumatology service, as well as the effectiveness rate of the procedure as a therapeutic method for chronic low back pain. Study Design:  retrospective cohort analytical observational study design. Place and Duration of Study: Sample: 48 patients with a diagnosis of lumbar facet syndrome treated by lumbar facet denervation (rhizolysis) by multimodal and multilevel radiofrequency between July 2021 and July 2022 at the Regional Military Hospital of specialties in Guadalajara, Jalisco were included. Methodology: Sample: We included data from the 48 patients who underwent radiofrequency facet denervation of the lumbar spine from L1 to L5, and their functional evolution was evaluated using the Oswestry Disability Index (ODI) and their analgesic evolution using the Visual Analog Scale (VAS). Results: Sample: Out of 48 patients, finding an average improvement of 5.6 ± 3.28 points in the visual analog pain scale and an improvement of 83.3% was obtained in patients with severe disability according to the Oswestry scale at 6 months of follow-up. There is a reduction of at least 3 points in VAS with a 50% reduction in pain and improvement in functional status. Effectiveness of 91.6% in the reduction of at least 16 points in ODI which represents the minimum score necessary to reduce 1 level of disability in the worst case scenario. Conclusion: The incidence of patients presenting to the orthopedic office with facet syndrome is 32.87%. Radiofrequency rhizolysis is an effective and safe treatment for the management of chronic low back pain in patients with facet syndrome, with a high rate of effectiveness and low rate of complications. The effectiveness of the treatment lies in the correct selection of the patient including clinical and imaging criteria and positive diagnostic block.