Intra-Articular vs Medial Branch Pulsed Radiofrequency in the Management of Lumbar Facet Joint-Related Low Back Pain: A Prospective Randomized Trial.

AIM: To compare the efficacy of intra-articular PRF (IA-PRF) and medial branch PRF (MB-PRF) in the treatment of facet joint-related low back pain.

MATERIAL AND

METHODS

In this prospective observational study, 116 patients with ≥50% pain relief after diagnostic intraarticular anesthetic injection were included. Patients underwent IA-PRF (n=60) or MB-PRF (n=56). Pain and disability were assessed using the Numerical Rating Scale (NRS) and Oswestry Disability Index (ODI) at baseline and 1 and 6 months post-treatment.

RESULTS

Both groups showed significant improvements in NRS and ODI scores at 1 and 6 months (p<0.001). In the IA-PRF group, NRS scores improved from 6.55 ± 0.65 to 3.23 ± 0.43 (1 month) and 3.70 ± 0.46 (6 months); ODI scores improved from 49.70 ± 3.75 to 25.13 ± 1.66 and 26.90 ± 2.13, respectively. In the MB-PRF group, NRS scores decreased from 6.43 ± 0.66 to 3.13 ± 0.33 (1 month) and 3.57 ± 0.49 (6 months); ODI scores decreased from 49.18 ± 3.49 to 24.71 ± 1.34 (1 month) and 26.68 ± 2.20 (6 months). No significant intergroup differences were observed at follow-ups (p>0.05). No complications occurred.

CONCLUSION

IA-PRF and MB-PRF are effective and safe in treating LFJ-induced pain after 6 months of follow-up. Significant pain control and functional improvement were achieved with both methods, with no significant difference between them regarding clinical efficacy. Our findings suggest that treatment selection should be individualized according to patient characteristics. Randomized studies with large samples and long-term follow-up are needed to improve the level of evidence in this field.