51. Lumbar Spondylolisthesis Progression: What is the Effect of Lumbar Medial Branch Nerve Radiofrequency Ablation on Lumbar Spondylolisthesis Progression? A Single-Center, Observational Study
- Author
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Patel,Trusharth, Watterson,Christopher, McKenzie-Brown,Anne Marie, Spektor,Boris, Egan,Katherine, Boorman,David, Patel,Trusharth, Watterson,Christopher, McKenzie-Brown,Anne Marie, Spektor,Boris, Egan,Katherine, and Boorman,David
- Abstract
Trusharth Patel,1 Christopher Watterson,2 Anne Marie McKenzie-Brown,3 Boris Spektor,3 Katherine Egan,3 David Boorman3 1Department of Anesthesiology, Division of Pain Management, Emory University School of Medicine, Atlanta, GA, 30308, USA; 2Department of Radiology, Emory University School of Medicine, Atlanta, GA, 30308, USA; 3Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, 30308, USACorrespondence: Trusharth PatelDepartment of Anesthesiology, Division of Pain Management, Emory University School of Medicine, 550 Peachtree Street NE, Atlanta, GA, 30308, USAEmail trusharth.patel@emory.eduBackground: Radiofrequency ablation (RFA) is a denervation therapy commonly performed for pain of facet etiology. Degenerative spondylolisthesis, a malalignment of the spinal vertebrae, may be a co-existing condition contributing to pain; yet the effect of RFA on advancing listhesis is unknown. To the extent that denervating RFA may weaken paraspinal muscles that provide stability to the spine, the therapy can potentially contribute to progressive spinal instability.Methods: Single-center, prospective, observational pilot study in an interventional pain practice to test the hypothesis that RFA of painful facets in the setting of spondylolisthesis may contribute to advancement of further degenerative spondylolisthesis. Fifteen participants with pre-existing degenerative Grade I or Grade II spondylolisthesis and coexisting axial lumbar pain underwent lumbar RFA encompassing spondylolisthesis level and followed with post-RFA imaging at 12 months and beyond to measure percent change in spondylolisthesis.Results: The primary outcome was the percent advancement of spondylolisthesis per year measured on post-RFA lateral lumbar spine imaging compared with non-intervention inferred baseline advancement of 2% per very limited observational studies. Among the 15 participants enrolled, 14 completed the study (median age 66; 64.3% women; median BMI 33.5; mean follow
- Published
- 2021