The effectiveness of cervical medial branch radiofrequency neurotomy using a perpendicular approach with a three-tined probe: A single-arm, retrospective cohort study
Bibliographic record
Abstract
Background: Cervical medial branch radiofrequency neurotomy (CMBRFN) with a parallel approach has been proven to be an effective treatment for zygapophyseal joint-mediated cervical pain. Technological advancements in radiofrequency probe design have allowed for a perpendicular approach to electrode placement. However, the effectiveness of the perpendicular approach remains to be fully understood. Objectives: Evaluate the effectiveness of CMBRFN with a perpendicular approach (pCMBRFN) in patients with confirmed zygapophyseal joint-mediated cervical pain. Methods: This single-arm, retrospective cohort study included patients identified between 2016 and 2022 who underwent pCMBRFN after demonstrating ≥80 % pain relief with two consecutive diagnostic medial branch blocks (MBB). Primary outcomes were ≥50 % patient-reported numeric rating scale (NRS) pain relief and minimal clinically important difference (MCID) on the Pain Disability Quality-Of-Life Questionnaire-Spine (PDQQ-S) at 3 months post-procedure. Secondary outcomes were mean patient-reported retrospective percentage pain relief and duration of relief after a successful pCMBRFN in individuals who presented for repeat pCMBRFN upon return of their symptoms. Results: ) were analyzed. At 3 months post-procedure, ≥50 % NRS pain reduction and MCID on PDQQ-S were both reported by 34 patients (65.4 % [95%CI 51.8-76.9]). Of the 34 patients with successful treatment response, 15 had return of symptoms after an average of 8.8 ± 2.5 months with a reported mean percentage pain relief of 86.0 ± 14.9 %. Conclusion: Within this cohort, pCMBRFN demonstrated effectiveness by reducing pain and disability in over 65 % of patients with confirmed cervical zygapophyseal joint-mediated pain at 3 months. Patients with successful treatment outcomes whose index symptoms eventually returned reported an average pain reduction of 86 % lasting approximately 9 months. Larger prospective studies with long-term follow-up are needed to confirm these results.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".