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Rate ePoster

Pain and Spine Medicine

A Retrospective Analysis and Predictors of Outcomes (PROMIS) Following Fluoroscopically Guided Lumbar Facet Radiofrequency Ablation

Saturday, October 25, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 10

    Poster Presenter(s)

  • Edgar Cedeno

    MS4
    Case Western Reserve University School of Medicine
    Shaker Heights, Ohio

    • Co-Author(s)

  • JW

    Jacquelyn Witzke, MD

    Medical Resident
    Mary Free Bed
    Grand Rapids, Michigan

  • KG

    Kush Goyal, MD

    Spine Medicine Staff Physician
    Cleveland Clinic Foundation
    Westlake, Ohio

Disclosure(s):
Edgar Cedeno: No financial relationships to disclose
Background and/or Objectives: This study aims to assess short and long-term clinical outcomes following lumbar facet radiofrequency ablation (RFA) in patients with confirmed facet joint low back pain, evaluating pain reduction, mood, and physical function using validated patient-reported outcome measures. We also examine demographic, clinical, imaging, and procedural factors to identify predictors of treatment response.

Design: Retrospective Observational Review

Setting : Tertiary Spine Center

Participants : We conducted a retrospective observational review of 147 patients who underwent lumbar medial branch RFA procedures by a single physician between 2013 and 2023. Eligibility required at least two positive diagnostic injections demonstrating ≥80% pain relief.

Interventions: Patients received fluoroscopically guided lumbar medial branch radiofrequency ablation for the treatment of lumbar facet-mediated pain.

Main Outcome Measures: Outcomes were assessed at approximately 3, 6, 12, and 24 months post-procedure. Primary outcomes included percent pain improvement and change in numeric rating scale (NRS) scores. Secondary outcomes included PHQ-9, PROMIS Global Mental Health, and PROMIS Global Physical Health measures.

Results: 147 patients were included in the analysis and they underwent 255 RFA procedures. The average baseline pain score was 6.7 on the NRS. More than two-thirds of patients achieved a minimally clinically important difference (MCID) of ≥2 points at 3, 6, 12, and 24 months, with mean NRS reductions of –3.00, –2.79, –2.68, and –2.90, respectively. Significant improvements were also seen in PHQ-9 scores at all time points except 24 months. PROMIS Physical Health improved at 3 months and 2 years, while PROMIS Mental Health showed no significant change. 33% of patients reduced or discontinued opioid use following the procedure.

Conclusions: Fluoroscopically guided lumbar medial branch RFA for treatment of lumbar facet-mediated pain is effective in providing therapeutic pain relief, reducing mean total percent pain by about 81% at 13.3 months after the procedure. Benefits may include improvements in depression and functional outcomes, along with reductions or discontinuation of opioid use.