Derby R, Vorobeychik Y, Schneider BJ, McCormick ZL. Comparison of two needle versus one needle lesioning techniques for thoracic medial branch neurotomy.
INTERVENTIONAL PAIN MEDICINE 2022;
1:100085. [PMID:
39239368 PMCID:
PMC11373022 DOI:
10.1016/j.inpm.2022.100085]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 09/07/2024]
Abstract
Background and objectives
No prior studies have investigated an assumed advantage of creating a radiofrequency strip lesion for posterior element spinal axial pain using a two-needle technique (TNT) compared to a one-needle technique (ONT) that creates a single ovoid lesion. We explore the relationship of TNT compared to ONT on the magnitude and duration of pain relief following thoracic medial branch neurotomy (TMBN).
Methods
This study is a retrospective audit of consecutive patients treated with TMBN at a single site and interventionalist over ten years (2007-2017). All patients had undergone TMBN after failed conservative care and, with few exceptions, patient-reported ≥ 70% pain relief after thoracic medial branch block (TMBB). All patients had TMBN performed with a medial to lateral (MLA) radiofrequency cannula approach using either an ONT or TNT technique. We used parametric and nonparametric statistics and three levels of case analysis to assess for intergroup differences.
Results
Thirty-five consecutive patients underwent their primary TMBN, and two underwent both on a subsequent repeat using the MLA approach, 19 using the ONT, 18 using the TNT. The TNT group had clinically and statistically greater pain relief magnitude and duration than the ONT subgroup. The difference resulted in non-overlapping 95% confidence intervals for both percent pain relief and duration of pain relief using three levels of case analysis.
Conclusion
The comparison of TMBN techniques demonstrates a statistically significant separation of TNT to ONT sample mean values for magnitude and duration of pain relief when using TNT compared to ONT for TMBN using an MLA.
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