Efficacy and Cost: Benefit Ratio of 0, 1, and 2 Medial Branch Blocks for Lumbar Facet Joint Radiofrequency Denervation
Status:
Completed
Trial end date:
2009-01-01
Target enrollment:
Participant gender:
Summary
Lumbar zygapophysial (facet) joint pain is a common cause of low back pain. Radiofrequency
(RF) denervation is an effective and low risk treatment of chronic low back pain of suspected
facet joint etiology. Blocks of the medial branches innervating the joints are commonly used
to localize the pain and make the diagnosis of facet joint pain.
There is currently no standard number of diagnostic blocks: zero, one, and two blocks have
all been utilized. Considering the high false positive and false negative rates of these
blocks, the cost: benefit ratio has been questioned. No study to date has examined the
practice of diagnostic medial branch blocks before RF denervation.
The purpose of this study is to determine the optimal number of blocks before radiofrequency
denervation. Three groups of patients will be studied. In group I, patients will undergo RF
denervation based on history and physical exam alone. In group II, patients will undergo RF
denervation based on a positive response to a single diagnostic block with local anesthetic.
In group III, patients will undergo RF treatment only after a positive screening block and a
positive confirmatory block.