Comparative Effectiveness of Two Different Approaches to Radiofrequency Ablation of Lumbar Medial Branch Nerves
The purpose of this voluntary research study is to determine whether the parasagittal approach to lumbar medial branch (LMB) nerve radio frequency ablation (RFA) will have greater efficacy than the traditional approach to lumbar medial branch nerve radio frequency ablation.
- EligibilityCriteria: Inclusion Criteria:  Bilateral equally intense axial low back pain Pain duration of ≥ 6 months Three-day average NRS scores of ≥ 3/10 Age greater than 18 years Failure of conservative treatment, including nonsteroidal anti-inflammatory medications and physical therapy Positive response to a series of two bilateral diagnostic lumbar medial branch nerve blocks (≥ 80% pain relief). This is the current standard of care.  Exclusion Criteria:  Radicular pain below the knee Systemic infection or localized infection at the anticipated introducer entry site Pregnancy Allergy to Lidocaine Bleeding dyscrasias Patients unable to give informed consent History of lumbar spine surgery at the affected levels History of previous bilateral lumbar RFA of medial branches within the past six months. Significant comorbid somatization or widespread pain with central sensitization Secondary gain identified due to ongoing legal proceedings or worker's compensation Cognitive impairment Any pre-existing condition at the discretion of the provider that may confound interpretation of results - - HealthyVolunteers: No - Gender: All - MinimumAge: 18 Years - StdAgeList: Adult, Older Adult