Complications of Lumbar Facet Radiofrequency Denervation

STUDY DESIGN: Retrospective. OBJECTIVE: To assess the incidence of complications associated with fluoroscopically guided percutaneous radiofrequency denervation of the lumbar facet joints. SUMMARY OF BACKGROUND DATA: Based on the results of previous efficacy studies, complications associated with facet joint radiofrequency denervation procedures appear to be rare. No formal safety assessment for this procedure has been performed to date. METHODS: We conducted retrospective chart reviews to identify complications that occurred within 8 weeks of facet joint radiofrequency denervation procedures performed at the Mayo Clinic in Jacksonville during a 5-year period. Only procedures that included radiofrequency electrode placement between the L1 transverse process and the sacral ala were included. The chart of each patient was reviewed and adjudicated by a panel of 4 physicians before being classified as a complication. RESULTS: Ninety-two patients received a total of 616 radiofrequency lesions during 116 separate denervation procedures. An average of 5 +/- 3 lesions were performed during each radiofrequency denervation procedure. Six minor complications were identified, yielding a 1.0% overall incidence of minor complications per radiofrequency site. Complications included: 3 cases of localized pain lasting more than 2 weeks (0.5%) and 3 cases of neuritic pain lasting less than 2 weeks (0.5%). No cases of infection, new motor deficits, or new sensory deficits were identified. CONCLUSIONS: Fluoroscopically guided percutaneous radiofrequency denervation of the lumbar facets is associated with an overall 1.0% incidence of minor complications per lesion site.