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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald

4 Issues per year

CiteScore 2017: 0.84

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Volume 18, Issue 4

The response to radiofrequency neurotomy of medial branches including a bipolar system for thoracic facet joints

Olav Rohof / Chee Kean Chen
  • Corresponding author
  • Department of Anesthesiology and Intensive Care, KPJ Kuching Specialist Hospital, Lot 10420, Block 11, Tabuan Stutong Commercial Centre, Jalan Setia Raja, 93350 Kuching, Sarawak, Malaysia, Phone: +6-082-365777, Fax: +6-082-364666
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Published Online: 2018-07-12 | DOI: https://doi.org/10.1515/sjpain-2018-0048


Background and aims

The evidence for interventional treatment of thoracic facet joint pain remains limited. This is partly due to inconsistency of the path of thoracic medial branches and a lower incidence of thoracic facet pain among spine pain patients. The purpose of this study is to evaluate the efficacy of bipolar radiofrequency (RF) neurotomy of medial branches for treating chronic thoracic facet joint pain.


This is a retrospective record review of all patients diagnosed to have thoracic facet pain with diagnostic block and subsequently treated with bipolar RF neurotomy of medial branch between January 2012 and December 2015. The outcome measures were mean changes in Numeral Rating Scale (NRS) and Pain Disability Index (PDI).


There were 71 patients with complete data available for analysis. The mean age of the patients was 57.9±11.2 years. The mean duration of pain was 23±10.5 months. The majority of patients (82%) had pain reduction of more than 50% at 12 months after bipolar RF neurotomy. The NRS decreased significantly from baseline of 7.75±1.25 to 2.86±1.53 at 3 months and 2.82±1.29 at 12 months post-procedure (p<0.001. p<0.001, respectively). The PDI improved significantly from 40.92±12.22 to 24.15±9.79, p<0.05). There were no serious adverse effects or complications of the procedure reported in this study.


Bipolar RF neurotomy of thoracic medial branch is associated with a significant reduction in thoracic facet joint pain. The promising findings from this case series merit further assessment with prospective, randomized controlled trial which will produce a more reliable and accurate finding for its clinical applications.

Keywords: bipolar; monopolar; radiofrequency; medial branch; thoracic facet joint


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About the article

Received: 2018-03-01

Revised: 2018-06-13

Accepted: 2018-06-20

Published Online: 2018-07-12

Published in Print: 2018-10-25

Authors’ statements

Research funding: This research did not receive any specific grant from funding agencies in public, commercial or not- for- profit sectors.

Conflict of interest: The authors declare that they have no conflict of interest.

Informed consent: Not applicable as this is a retrospective study, all data was de-identified and analyzed anonymously.

Ethical approval: This study was approved by institutional research review board with trial number 13-N-130 and was registered to the national trial registry with identifier number NTR 4294.

Authors’ contributions

RO was responsible for the development of study protocol and the design of the study. RO also involved in data collection and contributed to the manuscript writing. CKC performed the data analysis, contributed to the development of study protocol, the study design and manuscript writing. All authors read and approved the final manuscript.

Citation Information: Scandinavian Journal of Pain, Volume 18, Issue 4, Pages 747–753, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1515/sjpain-2018-0048.

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©2018 Scandinavian Association for the Study of Pain. Published by Walter de Gruyter GmbH, Berlin/Boston. All rights reserved..Get Permission

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