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

Background: Thoracic medial branch radiofrequency ablation (TMBRFA) is used to treat chronic thoracic spine pain, but data regarding its effectiveness and technique remain limited. Objectives: Evaluate outcomes of TMBRFA using a three-tined electrode in patients with thoracic facet joint pain. Methods: 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. Results: 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. Conclusion: 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.