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Pain and Spine Medicine

The Impact of Obesity on Lumbar Facet Joint Radiofrequency Ablation for the Management of Lumbar Spondylosis Related Low Back Pain

Saturday, October 25, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 10
Disclosure(s):
Grace Huffman, Other: No financial relationships to disclose
Ali Shakir, MD: No financial relationships to disclose
Zeinab Mohamed, PhD: No financial relationships to disclose
Background and/or Objectives: This study aimed to determine whether the presence of obesity and morbid obesity would impact therapeutic response to lumbar facet joint radiofrequency ablation (RFA) in treating lumbar facet-mediated low back pain.

Design: A retrospective cohort study. Subject data were divided into groups based on the presence of obesity and morbid obesity, as determined by their body mass index (BMI). A one-way analysis of variance (ANOVA) was used to assess the relationship between the presence of obesity and morbid obesity, and the numerical pain score reduction following RFA.

Setting : Single community-based physical medicine and rehabilitation clinic.

Participants : 172 patients who underwent lumbar facet joint radiofrequency ablation for the management of lumbar facet-mediated low back pain from January 1, 2019 through December 31, 2024.

Interventions: Not applicable.

Main Outcome Measures: Self-reported numeric pain score reduction 1-month after procedure.

Results: Of the 172 subjects who underwent lumbar facet RFA, 65 subjects had normal BMI, 76 subjects had obesity, and 31 subjects had morbid obesity. The normal BMI group had a mean pre-procedure pain score of 6.95 (SD=1.54) and a mean pain score reduction following the procedure of 4.48 (SD=1.75). Subjects with obesity had a mean pain score of 6.76 (SD=1.51) and a mean reduction following the procedure of 4.45 (SD=1.68). Subjects with morbid obesity had a mean pre-procedure pain score of 7.26 (SD=1.34) and a mean reduction following the procedure was 4.81 (SD=1.72). A one-way ANOVA comparing the three BMI groups did not reveal a statistically significant difference in pain score reduction among the groups (F(2,169) = 0.51, p = 0.601).

Conclusions: The results of our analysis indicate that the presence of obesity and morbid obesity does not have a significant impact on pain reduction following lumbar facet joint RFA. However, given the sample size, it is possible that the study was underpowered to detect a small but clinically meaningful difference.