Medial Branch Radiofrequency Ablation and Lumbar Multifidi



Status:Recruiting
Conditions:Arthritis, Osteoarthritis (OA)
Therapuetic Areas:Rheumatology
Healthy:No
Age Range:18 - Any
Updated:11/18/2018
Start Date:January 1, 2017
End Date:June 2020
Contact:Clark C. Smith, MD
Email:cs3028@cumc.columbia.edu
Phone:212-305-3535

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The Effect of Medial Branch Radiofrequency Ablation on Functional Spinal Stability and Lumbar Multifidi Muscle Architecture Assessed by Magnetic Resonance Imaging and Ultrasound Imaging

The purpose of this study is to evaluate the effects of lumbar medial branch radiofrequency
ablation (RFA) on lumbar multifidi muscle size and clinical spinal stability. Specifically,
this study is designed to highlight the comparison of multifidi muscle architecture using
ultrasound imaging (USI) and MRI before and after lumbar medial branch RFA. This study will
also include a commonly utilized functional assessment of the lumbar spine to evaluate the
effects of RFA on lumbar spinal stability.

Radiofrequency ablation (RFA) for the lumbar spine (lower back) is a procedure used to treat
lower back pain secondary to facet arthritis. The procedure ablates (burns) a small nerve
that goes to the arthritic joint in the back. This nerve also innervates a muscle called the
multifidus, thought to be important for lumbar stability. The investigators are conducting a
study to evaluate if RFA has any impact on multifidi size, spinal stability, and overall
function. The tools the investigators will be using to assess the multifidi muscles are
musculoskeletal ultrasound, MRI, physical therapy assessment, and functional questionnaires.
The goal of the study is to determine if RFA impacts the multifidi in a clinically
significant fashion, causing atrophy, spinal instability, and/or functional decline.

Inclusion criteria are:

- Aged over 18 years

- Presence of lumbar spondylosis or facet arthropathy (as determined by a radiologist)
*Unilateral back pain without radicular symptoms

- Positive physical findings for facet mediated pain (pain with lumbar extension and
rotation to affected side)

- Ability to complete outcome measure forms.

Exclusion criteria are:

- Prior spinal surgery

- Prior RFA procedures

- Pregnancy

- Contraindications to MRI

- Presence of therapeutic anti-coagulation, medical co-morbidities that would interfere
with the ability to perform the procedure safely

- Presence of neurologic changes

- Active tobacco smoking history

- Presence of active litigation

- Presence of open workers compensation case
We found this trial at
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New York, New York 10032
Principal Investigator: Clark C Smith, MD
Phone: 212-305-3535
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