Medial Branch Radiofrequency Ablation and Lumbar Multifidi

Columbia University

Status: Completed

Conditions: Osteoarthritis; Spondylosis

Treatments: Diagnostic Test: Patients undergo ultrasound and lumbar MRI

Study type: Observational

Funder types: Other

Identifiers

NCT03744260

AAAR1440

Details and patient eligibility

About

The purpose of this study is to evaluate the effects of lumbar medial branch radiofrequency ablation (RFA) on lumbar multifidi muscle size and clinical spinal stability. Specifically, this study is designed to highlight the comparison of multifidi muscle architecture using ultrasound imaging (USI) and MRI before and after lumbar medial branch RFA. This study will also include a commonly utilized functional assessment of the lumbar spine to evaluate the effects of RFA on lumbar spinal stability.

Full description

Radiofrequency ablation (RFA) for the lumbar spine (lower back) is a procedure used to treat lower back pain secondary to facet arthritis. The procedure ablates (burns) a small nerve that goes to the arthritic joint in the back. This nerve also innervates a muscle called the multifidus, thought to be important for lumbar stability. The investigators are conducting a study to evaluate if RFA has any impact on multifidi size, spinal stability, and overall function. The tools the investigators will be using to assess the multifidi muscles are musculoskeletal ultrasound, MRI, physical therapy assessment, and functional questionnaires. The goal of the study is to determine if RFA impacts the multifidi in a clinically significant fashion, causing atrophy, spinal instability, and/or functional decline.

Enrollment: 4 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion criteria are:

• Aged over 18 years
• Presence of lumbar spondylosis or facet arthropathy (as determined by a radiologist) *Unilateral back pain without radicular symptoms
• Positive physical findings for facet mediated pain (pain with lumbar extension and rotation to affected side)
• Ability to complete outcome measure forms.

Exclusion criteria are:

• Prior spinal surgery
• Prior RFA procedures
• Pregnancy
• Contraindications to MRI
• Presence of therapeutic anti-coagulation, medical co-morbidities that would interfere with the ability to perform the procedure safely
• Presence of neurologic changes
• Active tobacco smoking history
• Presence of active litigation
• Presence of open workers compensation case