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Radiofrequency lumbar facet denervation: a comparative study of the reproducibility of lesion size after 2 current radiofrequency techniques
  1. Evert J. Buijs, M.D.,
  2. Roelof M.A.W. van Wijk, M.D., Ph.D.,
  3. Jos W.M. Geurts, M.D., Ph.D.,
  4. Rolf R. Weeseman, M.D.,
  5. Robert J. Stolker, M.D., Ph.D. and
  6. Gerbrand G. Groen, M.D., Ph.D.
  1. From the Centre for Perioperative Medicine, Anesthesiology, and Pain Clinic, University Medical Centre Utrecht, Utrecht, The Netherlands (E.J.B., G.G.G.)
  2. Gelre Hospital, Department of Anesthesiology and Pain Clinic, Apeldoorn, The Netherlands (E.J.B.)
  3. Departments of Anaesthesia, the Royal Adelaide Hospital and the Queen Elizabeth Hospital, Adelaide, Australia (R.M.A.W.V.W.)
  4. Rijnstate Hospital, Department of Anesthesiology and Pain Clinic, Arnhem, The Netherlands (J.W.M.G.)
  5. Hilversum Hospital, Department of Anesthesiology and Pain Clinic, Hilversum, The Netherlands (R.R.W.)
  6. Catharina Hospital, Department of Anesthesiology and Pain Clinic, Eindhoven, The Netherlands (G.G.G.)
  1. Reprint requests: Evert J. Buijs, M.D., Department of Anesthesiology and Pain Clinic, Gelre Hospital, P.O. Box 9014, 7300 DS Apeldoorn, The Netherlands. E-mail: ejbuijs{at}


Background and objectives Radiofrequency facet denervation procedures are widely used for the treatment of chronic low-back pain. Currently, both temperature-controlled and voltage-controlled techniques are used. In this combined in vivo and in vitro study, the electrophysiologic consequences and the effects on lesion size of these techniques were determined.

Methods Thirty-three patients were randomly assigned to receive a lumbar radiofrequency facet denervation by using either temperature-controlled (80°C, 60 seconds) or voltage-controlled (20 V, 60 s) mode. Electrophysiologic parameters in both groups during radiofrequency lesioning were registered. Observed differences between electrodes were quantified and interpreted, using lesion-size data from egg-white experiments.

Results Seventeen patients in the temperature group were treated with a total of 55 radiofrequency lesions, all considered technically adequate. In the voltage-controlled group, 16 patients received 63 lesions. Of these, 44 (69.8%) procedures were found to be technically inadequate. Voltage-controlled radiofrequency lesioning resulted in uncontrollable fluctuations of temperature, with resultant uncontrollable variations in lesion size. Temperature-controlled mode created reproducible lesion sizes.

Conclusions There is no consistent relation between voltage and the temperature obtained during radiofrequency lumbar facet denervation. Temperature-controlled radiofrequency lesioning is preferred to create reproducible lesion sizes.

  • Effective radius
  • Lesion size
  • Low-back pain
  • Radiofrequency

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