{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T09:29:04Z","timestamp":1770110944457,"version":"3.49.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"13","license":[{"start":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,3,31]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The lumbar spine is a common cause of referred pain to the lower extremities. Standard conservative treatments (i.e., physical therapy and pharmacotherapy) can provide only partial or temporary relief, in which case injections might be used. This often consists of epidural steroid injections to treat possible radicular pain. When symptoms still persist, radiofrequency ablation (RFA) to treat facet-mediated pain can offer a viable option before surgical intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>In this illustrative case, a patient presenting with a complex array of worsening symptoms in the lower extremities, secondary to lumbar spondylosis, was treated using RFA. Conservative treatments resulted in partial, temporary relief. A facet-mediated source of pain was suspected, and diagnostic blocks indicated that the patient would be a candidate for bilateral RFA of the medial branches at L3, L4, and L5. Following the RFA procedure, the patient had full resolution of her lower extremity pain and paresthesias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>RFA procedures are typically performed to address low back pain rather than concomitant lower extremity pain and paresthesias. This case provides evidence indicating that, in the face of appropriate conservative management and diagnostic testing, RFA of the medial lumbar branches can address lower extremity pain secondary to lumbar spine pathology.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24837\">https:\/\/thejns.org\/doi\/10.3171\/CASE24837<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24837","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T23:49:59Z","timestamp":1743464999000},"source":"Crossref","is-referenced-by-count":0,"title":["The use of radiofrequency ablation for the management of refractory lower extremity pain associated with lumbar spondylosis: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"Vincent","family":"Codispoti","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Orthopaedic Associates of Hartford, Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Solomito","sequence":"additional","affiliation":[{"name":"Research Department, Hartford HealthCare Bone and Joint Institute, Hartford, Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"8","key":"bib1","series-title":"Ann Intern Med","first-page":"ITC113","article-title":"Low back pain","volume":"174","author":"Chou","year":"2021","unstructured":"Chou R.Low back pain. Ann Intern Med. 2021;174(8):ITC113-ITC128."},{"issue":"6","key":"bib2","series-title":"Ann Transl Med","first-page":"299","article-title":"Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017","volume":"8","author":"Wu","year":"2020","unstructured":"Wu AMarch LZheng XGlobal low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med. 2020;8(6):299-299."},{"issue":"3","key":"bib3","series-title":"Eur J Pain","first-page":"403","article-title":"Systematic review of patient history and physical examination to diagnose chronic low back pain originating from the facet joints","volume":"21","author":"Maas","year":"2017","unstructured":"Maas ETJuch JNSOstelo RWJGSystematic review of patient history and physical examination to diagnose chronic low back pain originating from the facet joints. Eur J Pain. 2017;21(3):403-414."},{"issue":"10070","key":"bib4","series-title":"Lancet","first-page":"736","article-title":"Non-specific low back pain","volume":"389","author":"Maher","year":"2017","unstructured":"Maher CUnderwood MBuchbinder R.Non-specific low back pain. Lancet. 2017;389(10070):736-747."},{"key":"bib5","series-title":"BMJ","first-page":"g6380","article-title":"Opioids for low back pain","volume":"350","author":"Deyo","year":"2015","unstructured":"Deyo RAVon Korff MDuhrkoop D.Opioids for low back pain. BMJ. 2015;350:g6380."},{"issue":"3","key":"bib6","series-title":"Anesthesiology","first-page":"517","article-title":"Effectiveness of lumbar facet joint blocks and predictive value before radiofrequency denervation: the Facet Treatment Study (FACTS), a randomized, controlled clinical trial","volume":"129","author":"Cohen","year":"2018","unstructured":"Cohen SPDoshi TLConstantinescu OCEffectiveness of lumbar facet joint blocks and predictive value before radiofrequency denervation: the Facet Treatment Study (FACTS), a randomized, controlled clinical trial. Anesthesiology. 2018;129(3):517-535."},{"issue":"1","key":"bib7","series-title":"J Orthop Surg Res","article-title":"A comparison of pulsed radiofrequency and radiofrequency denervation for lumbar facet joint pain","volume":"18","author":"Li","year":"2023","unstructured":"Li SJZhang SLFeng D.A comparison of pulsed radiofrequency and radiofrequency denervation for lumbar facet joint pain. J Orthop Surg Res. 2023;18(1):331."},{"issue":"7","key":"bib8","series-title":"Ann Intern Med","article-title":"Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians","volume":"166","author":"Qaseem","year":"2017","unstructured":"Qaseem AWilt TJMcLean RMNoninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530."},{"key":"bib9","series-title":"J Pain Res","first-page":"2859","article-title":"Efficacy of radiofrequency neurotomy in chronic low back pain: a systematic review and meta-analysis","volume":"14","author":"Janapala","year":"2021","unstructured":"Janapala RNManchikanti LSanapati MREfficacy of radiofrequency neurotomy in chronic low back pain: a systematic review and meta-analysis. J Pain Res. 2021;14:2859-2891."},{"issue":"6","key":"bib10","series-title":"Pain Physician","first-page":"E869","article-title":"An update of the systematic assessment of the diagnostic accuracy of lumbar facet joint nerve blocks","volume":"15","author":"Falco","year":"2012","unstructured":"Falco FJManchikantiL, DattaS, et al. An update of the systematic assessment of the diagnostic accuracy of lumbar facet joint nerve blocks. Pain Physician. 2012;15(6):E869-E907."},{"issue":"18","key":"bib11","series-title":"Pain Physician","first-page":"E497","article-title":"A best-evidence systematic appraisal of the diagnostic accuracy and utility of facet (zygapophysial) joint injections in chronic spinal pain","volume":"4","author":"Boswell","year":"2015","unstructured":"Boswell M.A best-evidence systematic appraisal of the diagnostic accuracy and utility of facet (zygapophysial) joint injections in chronic spinal pain. Pain Physician. 2015;18;4;4(18):E497-E533."},{"key":"bib12","series-title":"J Pain Res","first-page":"2807","article-title":"Latest evidence-based application for radiofrequency neurotomy (LEARN): best practice guidelines from the American Society of Pain and Neuroscience (ASPN)","volume":"14","author":"Lee","year":"2021","unstructured":"Lee DWPritzlaff SJung MJLatest evidence-based application for radiofrequency neurotomy (LEARN): best practice guidelines from the American Society of Pain and Neuroscience (ASPN). J Pain Res. 2021;14:2807-2831."},{"issue":"8","key":"bib1","series-title":"Ann Intern Med","first-page":"ITC113","article-title":"Low back pain","volume":"174","author":"Chou","year":"2021","unstructured":"Chou R.Low back pain. Ann Intern Med. 2021;174(8):ITC113-ITC128."},{"issue":"6","key":"bib2","series-title":"Ann Transl Med","first-page":"299","article-title":"Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017","volume":"8","author":"Wu","year":"2020","unstructured":"Wu AMarch LZheng XGlobal low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med. 2020;8(6):299-299."},{"issue":"3","key":"bib3","series-title":"Eur J Pain","first-page":"403","article-title":"Systematic review of patient history and physical examination to diagnose chronic low back pain originating from the facet joints","volume":"21","author":"Maas","year":"2017","unstructured":"Maas ETJuch JNSOstelo RWJGSystematic review of patient history and physical examination to diagnose chronic low back pain originating from the facet joints. Eur J Pain. 2017;21(3):403-414."},{"issue":"10070","key":"bib4","series-title":"Lancet","first-page":"736","article-title":"Non-specific low back pain","volume":"389","author":"Maher","year":"2017","unstructured":"Maher CUnderwood MBuchbinder R.Non-specific low back pain. Lancet. 2017;389(10070):736-747."},{"key":"bib5","series-title":"BMJ","first-page":"g6380","article-title":"Opioids for low back pain","volume":"350","author":"Deyo","year":"2015","unstructured":"Deyo RAVon Korff MDuhrkoop D.Opioids for low back pain. BMJ. 2015;350:g6380."},{"issue":"3","key":"bib6","series-title":"Anesthesiology","first-page":"517","article-title":"Effectiveness of lumbar facet joint blocks and predictive value before radiofrequency denervation: the Facet Treatment Study (FACTS), a randomized, controlled clinical trial","volume":"129","author":"Cohen","year":"2018","unstructured":"Cohen SPDoshi TLConstantinescu OCEffectiveness of lumbar facet joint blocks and predictive value before radiofrequency denervation: the Facet Treatment Study (FACTS), a randomized, controlled clinical trial. Anesthesiology. 2018;129(3):517-535."},{"issue":"1","key":"bib7","series-title":"J Orthop Surg Res","article-title":"A comparison of pulsed radiofrequency and radiofrequency denervation for lumbar facet joint pain","volume":"18","author":"Li","year":"2023","unstructured":"Li SJZhang SLFeng D.A comparison of pulsed radiofrequency and radiofrequency denervation for lumbar facet joint pain. J Orthop Surg Res. 2023;18(1):331."},{"issue":"7","key":"bib8","series-title":"Ann Intern Med","article-title":"Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians","volume":"166","author":"Qaseem","year":"2017","unstructured":"Qaseem AWilt TJMcLean RMNoninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530."},{"key":"bib9","series-title":"J Pain Res","first-page":"2859","article-title":"Efficacy of radiofrequency neurotomy in chronic low back pain: a systematic review and meta-analysis","volume":"14","author":"Janapala","year":"2021","unstructured":"Janapala RNManchikanti LSanapati MREfficacy of radiofrequency neurotomy in chronic low back pain: a systematic review and meta-analysis. J Pain Res. 2021;14:2859-2891."},{"issue":"6","key":"bib10","series-title":"Pain Physician","first-page":"E869","article-title":"An update of the systematic assessment of the diagnostic accuracy of lumbar facet joint nerve blocks","volume":"15","author":"Falco","year":"2012","unstructured":"Falco FJManchikantiL, DattaS, et al. An update of the systematic assessment of the diagnostic accuracy of lumbar facet joint nerve blocks. Pain Physician. 2012;15(6):E869-E907."},{"issue":"18","key":"bib11","series-title":"Pain Physician","first-page":"E497","article-title":"A best-evidence systematic appraisal of the diagnostic accuracy and utility of facet (zygapophysial) joint injections in chronic spinal pain","volume":"4","author":"Boswell","year":"2015","unstructured":"Boswell M.A best-evidence systematic appraisal of the diagnostic accuracy and utility of facet (zygapophysial) joint injections in chronic spinal pain. Pain Physician. 2015;18;4;4(18):E497-E533."},{"key":"bib12","series-title":"J Pain Res","first-page":"2807","article-title":"Latest evidence-based application for radiofrequency neurotomy (LEARN): best practice guidelines from the American Society of Pain and Neuroscience (ASPN)","volume":"14","author":"Lee","year":"2021","unstructured":"Lee DWPritzlaff SJung MJLatest evidence-based application for radiofrequency neurotomy (LEARN): best practice guidelines from the American Society of Pain and Neuroscience (ASPN). J Pain Res. 2021;14:2807-2831."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/13\/article-CASE24837.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/13\/article-CASE24837.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/13\/article-CASE24837.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T23:40:45Z","timestamp":1770075645000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/13\/article-CASE24837.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,31]]},"references-count":24,"journal-issue":{"issue":"13"},"URL":"https:\/\/doi.org\/10.3171\/case24837","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,31]]}}}