Successful Lumbar Radiofrequency Denervation in a Patient With Severe Degenerative Lumbar Spine Disease
Background
An 81-year-old gentleman was referred to Dr Krishna at Pain Spa Bristol for specialist assessment and management of chronic low back pain. He had been suffering from mechanical lumbar pain for several years, worsening over the past 18 months. His pain was constant across the lower back, aggravated by standing and walking, and relieved by sitting or lying down. His mobility, function, and ability to manage daily activities had significantly declined.
Prior to attending Pain Spa, he underwent diagnostic lumbar medial branch blocks, which produced a positive response — confirming facet joint-mediated low back pain. He was therefore considered an appropriate candidate for lumbar radiofrequency denervation, a minimally invasive treatment for facet joint pain.
Clinical Findings and Imaging
MRI imaging demonstrated advanced multilevel degenerative disc disease, lumbar kyphoscoliosis, facet joint hypertrophy, and severe foraminal narrowing — all common contributors to degenerative spine pain. These findings supported the diagnosis of facetogenic back pain, a leading indication for radiofrequency ablation for back pain.
On examination, he exhibited a fixed flexed posture from lumbar kyphoscoliosis, lower lumbar paraspinal tenderness, and bilateral sacroiliac joint tenderness. Functionally, he remained significantly restricted.
Treatment
The patient underwent bilateral lumbar radiofrequency denervation under fluoroscopic guidance as advised by Dr Krishna. Despite the complexities of his degenerative spine, the procedure was completed successfully with accurate placement of radiofrequency probes at the targeted medial branches.
Outcome
At his eight-week follow-up, the patient reported a remarkable clinical response, noting that the radiofrequency treatment “kicked in quite rapidly.” He experienced:
- Almost complete resolution of back pain
- Significant improvement in mobility
- Ability to manage stairs without difficulty
- Improved sleep quality
Functionally, he had returned to a much higher level of activity and was able to resume daily tasks that were previously limited by pain. His medication regimen was adjusted accordingly, with a planned gradual reduction of painkillers due to the sustained improvement.
Conclusion
This case highlights the effectiveness of lumbar radiofrequency denervation in older patients with chronic mechanical low back pain, even in the presence of severe degenerative spinal disease and scoliosis. Despite anatomical complexity, expert-performed radiofrequency denervation resulted in near-complete pain relief and substantial improvement in functional ability.
Dr. Krishna’s extensive experience in fluoroscopy-guided spinal procedures and his specialist expertise in pain medicine played a key role in achieving an excellent clinical outcome for this patient.
Pain Spa Bristol continues to offer specialist care for patients with chronic back pain, especially those requiring advanced treatments such as radiofrequency ablation, medial branch blocks, and image-guided spinal procedures.
Why Radiofrequency Denervation Requires Specialist Expertise
Lumbar radiofrequency denervation is a highly skilled procedure requiring advanced knowledge of:
- Medial branch nerve anatomy
- Facet joint orientation
- Fluoroscopy-guided spinal interventions
- Needle trajectory in the presence of scoliosis or collapsed joints
In complex cases like this, expertise is crucial. Back pain specialists with extensive interventional experience — such as Dr Krishna — are best placed to perform radiofrequency ablation safely and effectively, particularly in patients with severe degenerative spinal changes.
This is one of the reasons Pain Spa Bristol is recognised for specialist interventional pain management.
For more information about lumbar facet joint radiofrequency treatment or to find out if this procedure may be suitable for you, please visit www.painspa.co.uk or email us at clinic@painspa.co.uk for further details.