Technical Description of Cooled Radiofrequency Ablation of Lumbar Medial Branches for the Treatment of Lumbar Facet Pain

Exclusion Criteria

• •1. Current pregnancy, currently breast feeding or the intent of becoming pregnant during the study period
• •2. Prior posterior lumbar fusion
• •3. Prior low back surgery
• •4. Concurrent cervical or thoracic pain or pain in these regions lasting longer than 2 weeks during the last 6 months
• •5. Compensable disability or work injury or ongoing litigation
• •6. Prior treatment with radiofrequency neurotomy in the lumbar region within 3 months
• •7. Discogenic pain verified by controlled discography
• •8. Sources of pain not in the lumbar spine
• •9. Leg pain greater than back pain
• •10. Obvious inappropriate pain behavior during physical exam
• •11. Neurologic deficits
• •12. Positive straight leg raising result
• •13. Any features of upper motor neuron lesion
• •14. Gait abnormality not attributable to spinal pain
• •15. Severe Central Spinal Canal Stenosis (\> 50%) evident on prior computed tomogram or magnetic resonance image
• •16. Spondylolysis
• •17. Spondylolisthesis
• •18. More than 75% narrowing of a disc space on plain radiographs
• •19. Spondyloarthropathy
• •20. Score higher than 20 on the Beck Depression Inventory
• •21. Patients addicted to alcohol, narcotics or other illegal substances
• •22. Dependence on opioids
• •23. Uncontrolled acute/chronic illness that may confound interpretation of outcome measures
• •24. Allergy to injectants, medication or anesthetics to be used
• •25. Active or uncontrolled rheumatoid arthritis or other autoimmune diseases
• •26. Patients with a history of mental instability or diagnosed with a mental disorder
• •27. Patient unwilling or unable to comply with study procedures or follow-up visits
• •28. The presence of a pacemaker in the patient