The effectiveness of thoracic medial branch radiofrequency ablation using a three-tined electrode: A real-world cross-sectional cohort study

TL;DR

This study examines the effectiveness of a three-tined electrode for thoracic medial branch radiofrequency ablation in treating chronic thoracic spine pain.

Contribution

The study provides real-world evidence on the use of a three-tined electrode for TMBRFA in a clinical setting.

Findings

Approximately 36.4% of patients experienced ≥50% pain reduction at an average follow-up of 20.6 months.

54.6% of patients reported significant overall improvement in their condition.

Two patients stopped using opioids, showing a 18.2% proportional decrease in opioid use.

Abstract

Thoracic medial branch radiofrequency ablation (TMBRFA) is used to treat chronic thoracic spine pain, but data regarding its effectiveness and technique remain limited.

Evaluate outcomes of TMBRFA using a three-tined electrode in patients with thoracic facet joint pain.

Consecutive patients who underwent first-time TMBRFA at a single tertiary academic center between 2022 and 2024 were identified and contacted for follow-up via standardized telephone survey at ≥6 months post-procedure. Baseline demographic and clinical data were extracted from electronic medical records. Outcomes included the proportions of patients with ≥50% numerical rating scale (NRS) pain score reduction, ≥2-point NRS reduction, and Patient Global Impression of Change (PGIC) scores ≥6 (indicating at least “much improved”). Mean NRS pain score reduction and changes in opioid use from baseline were also assessed.

Outcomes were successfully collected from 11 patients. At a mean follow-up of 20.6 ± 7.6 months, 36.4% (95%CI: 15.2–64.6) and 45.5% (95%CI: 21.3–72.0) of patients reported ≥50% and ≥2-point NRS reductions, respectively, with 54.6% (95%CI: 28.0–78.7) reporting PGIC scores ≥6. Mean NRS pain score reduction was 1.9 ± 2.7 points. Two patients had ceased using opioids at follow-up, representing a proportional decrease of 18.2% compared to baseline.

In this cohort, approximately half of patients who underwent first-time TMBRFA with a three-tined electrode experienced clinically meaningful pain relief and perceived overall improvement at an average follow-up of nearly 2 years. Larger, prospective studies are needed to corroborate these findings.

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