Comparative Outcomes and Safety of Radiofrequency Ablation and Cryoablation for Lumbar Facet Joint Degeneration: A Single-Center Retrospective Cohort Study with 24-Month Follow-Up.

Background

Lumbar facet joint degeneration is a common source of chronic low back pain. Radiofrequency (RF) ablation is widely used, whereas cryoablation (CA) remains less extensively investigated. Evidence directly comparing the long-term outcomes of these two modalities is scarce, particularly beyond 12 months.

Methods

This single-center retrospective cohort study analyzed patients with lumbar facet joint degeneration who underwent RF (n = 97) or CA (n = 83). Clinical data were retrieved from institutional records. Pain intensity (VAS), functional outcomes (ODI and RMDQ), and quality-of-life measures (EQ-5D and SF-36) were assessed at baseline and at 1, 3, 6, 12, 18, and 24 months. The primary outcome was change in ODI; secondary outcomes included VAS, RMDQ, quality of life, and complications. Clinically meaningful improvement was defined according to Minimal Clinically Important Difference (MCID) and Patient Acceptable Symptom State (PASS) thresholds.

Results

Both RF and CA significantly improved pain and function compared with baseline. RF demonstrated superior reductions in ODI and VAS at 12 and 18 months (p < 0.05); however, by 24 months, treatment effects had diminished, and no significant differences remained (p > 0.05). Quality-of-life improvements plateaued after 18 months in both groups. Minor complications occurred in 9.3% of RF cases and 6.0% of CA cases; no major adverse events were observed.

Conclusions

RF provided earlier and more pronounced benefits in pain and function up to 18 months, whereas both RF and CA showed reduced but comparable effectiveness at 24 months. These findings support RF as a preferred interventional option for robust short- to mid-term outcomes, with CA serving as a safe long-term alternative. However, the single-center retrospective design and potential observer bias limit generalizability. Future multicenter prospective studies are warranted.