The effect of lumbar medial branch radiofrequency neurotomy on cobb angle progression in individuals with adult scoliosis compared to natural history: A cross-sectional study.

Caragea, Marc; Le, Austin; Curtis, Tim; Ni, Amelia; Clark, Tyler; Joyce, Andrew; Hickman, Colton; Lawrence, Brandon; Randell, Zane; Goodman, Perry; Poduska, Addisyn; Rasmussen, Michella; Cooper, Amanda; Teramoto, Masaru; Glinka Przybysz, Allison; Burnham, Taylor; Conger, Aaron; McCormick, Zachary L

Caragea, Marc; Le, Austin; Curtis, Tim; Ni, Amelia; Clark, Tyler; Joyce, Andrew; Hickman, Colton; Lawrence, Brandon; Randell, Zane; Goodman, Perry; Poduska, Addisyn; Rasmussen, Michella; Cooper, Amanda; Teramoto, Masaru; Glinka Przybysz, Allison; Burnham, Taylor; Conger, Aaron; McCormick, Zachary L.

Caragea M; Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA.
Le A; Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA.
Curtis T; Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA.
Ni A; Department of Orthopedics, Division of Physical Medicine and Rehabilitation, Washington University in St. Louis, St. Louis, MO, USA.
Clark T; Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA.
Joyce A; Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA.
Hickman C; Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA.
Lawrence B; Department of Orthopedics, University of Utah School of Medicine, Salt Lake City, UT, USA.
Randell Z; School of Medicine, University of Utah, Salt Lake City, UT, USA.
Goodman P; School of Medicine, University of Utah, Salt Lake City, UT, USA.
Poduska A; School of Medicine, University of Utah, Salt Lake City, UT, USA.
Rasmussen M; School of Medicine, University of Utah, Salt Lake City, UT, USA.
Cooper A; Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA.
Teramoto M; Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA.
Glinka Przybysz A; Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA.
Burnham T; Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA.
Conger A; Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA.
McCormick ZL; Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA.

Interv Pain Med ; 3(2): 100411, 2024 Jun.

Article en En | MEDLINE | ID: mdl-39238576

ABSTRACT

ABSTRACT

Background:

Lumbar radiofrequency neurotomy (LRFN) effectively alleviates zygapophyseal joint-mediated pain by coagulating medial branch nerves to disrupt nociceptive signaling pathways. The concomitant denervation of multifidus fibers has led to concern that LRFN may increase segmental instability and accelerate degenerative changes in patients with certain pre-existing spinal pathologies. There is a paucity of literature evaluating whether LRFN increases the progression of spinal curvature in patients with adult scoliosis.

Objective:

Compare the lumbosacral Cobb angle progression rate in patients with adult scoliosis who underwent LRFN to the annual progression rate of 0.83 ± 1.1° expected by natural history.

Design:

Cross-sectional study.

Methods:

Consecutive patients diagnosed with adult scoliosis who underwent LRFN to treat zygapophyseal joint-related low back pain were identified. Patient demographics, LRFN procedure details, and radiographs confirming scoliosis were collected from electronic medical records. Pre- and post-LRFN radiographs were used to calculate the average annual rate of Cobb angle progression. Data were analyzed using a Wilcoxon signed-rank test and a linear regression model.

Results:

Sixty patients (mean age 69.2 ± 11.6 years; 70.0 % female) met the criteria and were included in the analyses. The mean time to radiographic follow-up was 35.0 ± 22.7 months post-LRFN. The average Cobb angle progression was 0.54 ± 3.03° per year and did not differ significantly from the known natural progression rate of 0.83 ± 1.1° per year. None of the included covariates (body mass index, LRFN laterality, and number of levels denervated) were significantly associated with the average annual Cobb angle progression rate.