biostudies-literatureUnknown24(12)McCormick ZLUniversity of Utah Judith Victor Spine Research GrantUniversity of Utah Judith Victor Spine ResearchUniversity of Utah Carol and Leonard Raizin Spine Research GrantAvanos Medicalinvestigator-initiated research grant from Avanos MedicalUniversity of Utah Carol and Leonard Raizin Spine Research<h4>Background</h4>Lumbar medial branch radiofrequency ablation (LRFA) and intraarticular facet steroid injections (FJI) are commonly performed for recalcitrant facet joint-mediated pain. However, no study has compared clinical outcomes of the two treatments in patients selected using dual medial branch blocks (MBBs) with an 80% relief threshold.<h4>Objective</h4>Compare the effectiveness of cooled LRFA (C-LRFA) to FIJ as assessed by pain and functional improvements.<h4>Design</h4>Prospective randomized comparative trial.<h4>Methods</h4>Patients with dual MBB-confirmed facet joint-mediated pain were randomized to receive C-LRFA or FIJ. Outcomes were assessed at 1, 3, 6, and 12 months. The primary outcome was ≥50% improvement in numerical pain rating scale (NPRS) score at 3 months. Secondary outcomes included ≥30% Oswestry Disability Index (ODI) improvement and Patient Global Impression of Chance (PGIC) ≥6 points, among others. Data were analyzed using contingency tables and mixed-effects logistic regression models.<h4>Results</h4>Of 1128 patients screened, 32 met eligibility criteria, were randomized, and received their allocated study treatment. In total, 20 (62.5%) and 12 (37.5%) participants received C-LRFA and FIJ, respectively. In the C-LRFA group, 70% (95% CI 48-85), 55% (95% CI 34-74), and 45% (95% CI 26-66) of participants met the NPRS responder definition, compared to 25% (95%CI 9-53), 25% (95% CI 9-53), and 17% (95% CI 5-45) in the FJI group at 3, 6, and 12 months, respectively (P = .014 at 3 months). The PGIC responder proportion was higher in the C-LRFA compared to FJI group at 3 and 6 months (P < .05).<h4>Conclusions</h4>C-LRFA demonstrated superior success rates compared to FJI across pain and functional outcome domains.<h4>Trial registration details</h4>ClinicalTrials.gov (NCT03614793); August 3, 2018.Pain medicine (Malden, Mass.)1318-1331https://www.ebi.ac.uk/biostudies/studies/S-EPMC10690866biostudies-literatureA pragmatic randomized prospective trial of cooled radiofrequency ablation of the medial branch nerves versus facet joint injection of corticosteroid for the treatment of lumbar facet syndrome: 12 month outcomes.PMC10690866Conger ASperry BPCooper ANBurnham TRTeramoto MWagner GLittell MMcCormick ZLKendall RHenrie AMPetersen RfalseA pragmatic randomized prospective trial of cooled radiofrequency ablation of the medial branch nerves versus facet joint injection of corticosteroid for the treatment of lumbar facet syndrome: 12 month outcomes.<h4>Background</h4>Lumbar medial branch radiofrequency ablation (LRFA) and intraarticular facet steroid injections (FJI) are commonly performed for recalcitrant facet joint-mediated pain. However, no study has compared clinical outcomes of the two treatments in patients selected using dual medial branch blocks (MBBs) with an 80% relief threshold.<h4>Objective</h4>Compare the effectiveness of cooled LRFA (C-LRFA) to FIJ as assessed by pain and functional improvements.<h4>Design</h4>Prospective randomized comparative trial.<h4>Methods</h4>Patients with dual MBB-confirmed facet joint-mediated pain were randomized to receive C-LRFA or FIJ. Outcomes were assessed at 1, 3, 6, and 12 months. The primary outcome was ≥50% improvement in numerical pain rating scale (NPRS) score at 3 months. Secondary outcomes included ≥30% Oswestry Disability Index (ODI) improvement and Patient Global Impression of Chance (PGIC) ≥6 points, among others. Data were analyzed using contingency tables and mixed-effects logistic regression models.<h4>Results</h4>Of 1128 patients screened, 32 met eligibility criteria, were randomized, and received their allocated study treatment. In total, 20 (62.5%) and 12 (37.5%) participants received C-LRFA and FIJ, respectively. In the C-LRFA group, 70% (95% CI 48-85), 55% (95% CI 34-74), and 45% (95% CI 26-66) of participants met the NPRS responder definition, compared to 25% (95%CI 9-53), 25% (95% CI 9-53), and 17% (95% CI 5-45) in the FJI group at 3, 6, and 12 months, respectively (P = .014 at 3 months). The PGIC responder proportion was higher in the C-LRFA compared to FJI group at 3 and 6 months (P < .05).<h4>Conclusions</h4>C-LRFA demonstrated superior success rates compared to FJI across pain and functional outcome domains.<h4>Trial registration details</h4>ClinicalTrials.gov (NCT03614793); August 3, 2018.2023-01-01T00:00:00Z2023 Dec2025-04-25T17:35:49.181Z2025-04-06T04:05:23.589ZS-EPMC106908663757843710.1093/pm/pnad107