Treatment of pain in degenerative spine – radiofrequency ablation

Medical Review (Med. pregled), 2024, 60(6), 43-47.

Vl. Andonov, A. Dzherov

Spine Surgery Clinic, USHATO „Prof. B. Boychev“; Department of Orthopedics and Traumatology, Medical University – Sofia

Abstract. Pain has a defensive mechanism and is defined as unpleasant biopsychosocial phenomenon in response to actual or potential destruction of tissue in the body. Current understanding of pain management requires multimodal approach – including but not limited to medical treatment, rehabilitation and physiotherapy, cognitive behavioral therapy, operative management, etc. Modern method for treatment of pain is radiofrequency ablation. Radiofrequency ablation is based on thermal destruction of the peripheral nerves which results in suppression of the transfer of pain signals to the central nervous system. This nonoperative procedure finds wide application in spinal surgery. In the period 2020-2022, 63 patients were treated with radiofrequency ablation. All of them had symptoms of low back pain. All of the patients were diagnosed with degenerative arthritis – facet joint disease, sacroiliitis. The patients were followed up for 12 months after the procedure. Oswestry Disability Questionnaire and Pain Visual Analog Scale were used as subjective methods for classifying the functional impairment and severity of pain of the patients. After the procedure functional impairment was grade 1 – No disability – for Oswestry Disability Questionnaire, and pain severity was 1/10 for Pain Visual Analog Scale. The low risk and positive effect on pain makes radiofrequency ablation preferred method for pain management especially in patients with degenerative facet disease.

Key words: sacroiliitis, facet joint disease, low back pain, facet syndrome, pain management, radiofrequency ablation, termodenervation

Address for correspondence: Vladislav Andonov, MD, e-mail: vladislavandonovbo@gmail.com