Principal Investigator: Zachary McCormick
Keywords: Medial Branch Block , Facet Joint Injection , Prospective trial , Radiofrequency Ablation , Low back pain , Lumbar Facet Joint Pain Department: Physical Medicine & Rehab
IRB Number: 00111315 Co Investigator: Nick Monson
Specialty: Physical Medicine and Rehabilitation
Sub Specialties: Back
Recruitment Status: Recruiting

Contact Information

Russell Petersen

Simple Summary

Determine if individuals with lumbar facet syndrome who are treated with C-RFA of the MBNs compared to facet joint injection of corticosteroid have a greater likelihood of experiencing meaningful relief of low back pain symptoms, functional improvement, and reduction of analgesic medication use at both short and long-term follow-up.

Inclusion Criteria

Inclusion Criteria:

  1. Adult patients aged > 21 capable of understanding and providing consent in English and capable of complying with the outcome instruments used.
  2. Axial (non-radicular) back pain for at least 3 months (ie Chronic Low Back Pain), with pain lasting at least half of the days within those 3 months, that did not respond to conventional treatment such as physical therapy, oral analgesic agents, and non-invasive adjunctive treatments. The pain can be unilateral or bilateral. The pain can also include referred lower limb pain.
  3. 7-day worst numeric pain rating score (NPRS) for back pain of 5/10 or greater at baseline evaluation.
  4. Positive responses to dual comparative diagnostic MBN blocks using 0.5mL of 0.5% bupivacaine and 4% lidocaine, on respective encounters on separate days, at each of the appropriate MBNs. The blocks are administered in a double-blind fashion so that neither the subject nor the independent assessor is aware of the local anesthetic used.

Exclusion Criteria

  1. Focal neurologic signs or symptoms.
  2. Radiologic evidence of a symptomatic herniated disc or nerve root impingement related to spinal stenosis.
  3. Active systemic or local infections at the site of proposed needle and electrode placement.
  4. Coagulopathy or other bleeding disorder.
  5. Receipt of remuneration for their pain treatment (e.g. disability, worker’s compensation, auto injury in litigation or pending litigation).
  6. History of any lumbar or lower thoracic fusion surgery or placement of other hardware.
  7. Grade 2 Spondylolisthesis at an affected or adjacent level.
  8. Cobb angle >10 degrees.
  9. Sagittal vertical axis angle >5 degrees.
  10. BMI >40.
  11. Incarceration.
  12. Cognitive deficit affecting ability to complete the assessment instruments.
  13. Inability to read English and complete the assessment instruments.
  14. Allergy to local anesthetics.
  15. Chronic widespread pain or somatoform disorder (e.g. fibromyalgia).
  16. Prior lumbar MBN radiofrequency neurotomy.
  17. Addictive behavior, severe clinical depression, anxiety, or any mental health condition with psychotic features.
  18. Possible pregnancy or other reason that precludes the use of fluoroscopy.
  19. Daily chronic opiate use of >50 morphine equivalents.

Participant Reimbursement

No reimbursement but there is compensation.Participants will receive three $50 Amazon gift cards if they complete all surveys. Gift cards will be distributed upon completion at the 3-month, 1-year, and 2-year survey time. Gift cards will be mailed 1-2 weeks after completion at those time periods.