Clinical Outcomes of Conventional Versus Lateral-Deployment RF Cannulas in Lumbar Medial Branch Radiofrequency Ablation: A Prospective Randomized Study
In brief
Lateral-deployment cannula doubled rates of 50% pain relief after lumbar ablation
In this randomized trial, 74% of patients treated with a lateral-deployment cannula had at least 50% pain reduction at 6 months, versus 38% with a conventional cannula; pain and disability improvements also favored the lateral design. The results suggest cannula choice may affect outcomes, but only 84 of 90 randomized participants had complete 6-month data, and larger trials are needed.
- Journal
- American journal of physical medicine & rehabilitation (Q1)
- Published
- 22 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Ecem Kahraman, Alp Eren Çelenlioğlu, Sami Eksert, Mehmet Emin İnce, Fatih Şimşek, Ender Sir, et al.
- PMID
- 42908078
- DOI
- 10.1097/PHM.0000000000003187
Why clinicians should know about it
- Picked for Anesthesiology and Pain Medicine (paper of the day, 23 October 2026): Randomized comparison of lumbar medial branch radiofrequency techniques
Abstract
OBJECTIVE: To compare conventional monopolar and lateral-deployment RF cannulas for lumbar medial branch radiofrequency ablation (RFA) in chronic facet-mediated low back pain. DESIGN: Single-center, randomized, participant-blinded, two-arm superiority trial. Ninety participants were randomized 1:1; 84 with complete 6-month data were analyzed. The primary outcome was change in Numeric Rating Scale (NRS) pain intensity from baseline to 6 months. Secondary outcomes were changes in the Modified Oswestry Disability Index (MODI) and SF-12 Physical (PCS) and Mental (MCS) Component Scores. RESULTS: Mean NRS change was -2.81 points with the conventional cannula and -5.52 points with the lateral-deployment cannula. The age-adjusted between-group difference was -2.795 points (95% CI, -3.967 to -1.624; P<0.001). At 6 months, at least 50% NRS reduction was achieved by 16/42 (38.1%) and 31/42 (73.8%) participants, respectively (risk ratio, 1.94; 95% CI, 1.27-2.97; P=0.001). Age-adjusted MODI and SF-12 PCS changes favored the lateral-deployment cannula. No major procedure-related complications were observed. CONCLUSION: The lateral-deployment cannula was associated with greater 6-month improvements in pain, disability, and physical health and with more participants achieving substantial pain relief. Larger trials with intention-to-treat analyses are needed.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.