초록접수[미리보기]
| 21KF-045 |
SPECT-CT in predicting the therapeutic effect of radiofrequency ablation
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea1
Background: Medial branch block and intra-articular facet injections are performed to treat facet joint pain. In order to maintain the treatment effect for a long time, radiofrequency ablation is used in patients who have been effective in the treatment. So far, only a favorable response for a diagnostic block has been regarded as a predictive factor for successful outcome of radiofrequency treatment. Single photon emission computed tomography-CT (SPECT-CT) has been suggested as a diagnostic tool to define facet arthropathy. This study was performed to identify an association between the facet arthropathy findings in SPECT-CT and the RF treatment outcomes.
Methods: A total of 10 patients who underwent thermal radiofrequency ablation from 2018 to 2021 in our clinic were enrolled. All of the enrolled patients had positive SPECT-CT findings interpreted as facet arthropathy and degenerative changes in lumbar spine. Before the RF treatment, two trials of diagnostic medial branch blocks were performed. Patients’ demographic characteristics including BMI, medical history, and previous spinal surgery history were assessed. As for pain related data, pain duration and pain score before the RF treatment were evaluated via both patient survey and physician’s report. One month after the RF treatment, the pain score and treatment related complication were assessed.
Results: The median pre-RF pain score was 6 (range, 2~9) and the median post-RF pain score was 5 (range, 1~9). In addition, the median value of pain score reduction was 1 (range, -3~3). Physician reported 5 out of 10 patients showed symptom relieve more than 50%.
Conclusions: In this study, only half of the patients with the positive findings on SPECT-CT showed favorable effects on RF treatment. Thus, favorable RF outcome cannot be guaranteed despite positive findings on SPECT-CT. A larger-scale study is needed to establish the concrete relationships.
Methods: A total of 10 patients who underwent thermal radiofrequency ablation from 2018 to 2021 in our clinic were enrolled. All of the enrolled patients had positive SPECT-CT findings interpreted as facet arthropathy and degenerative changes in lumbar spine. Before the RF treatment, two trials of diagnostic medial branch blocks were performed. Patients’ demographic characteristics including BMI, medical history, and previous spinal surgery history were assessed. As for pain related data, pain duration and pain score before the RF treatment were evaluated via both patient survey and physician’s report. One month after the RF treatment, the pain score and treatment related complication were assessed.
Results: The median pre-RF pain score was 6 (range, 2~9) and the median post-RF pain score was 5 (range, 1~9). In addition, the median value of pain score reduction was 1 (range, -3~3). Physician reported 5 out of 10 patients showed symptom relieve more than 50%.
Conclusions: In this study, only half of the patients with the positive findings on SPECT-CT showed favorable effects on RF treatment. Thus, favorable RF outcome cannot be guaranteed despite positive findings on SPECT-CT. A larger-scale study is needed to establish the concrete relationships.
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