{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T13:36:54Z","timestamp":1793367414324,"version":"4.5.0"},"reference-count":54,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: Sarcopenia is defined by the progressive loss of muscle mass, strength, and\/or physical performance associated with aging. Radiofrequency ablation (RFA) of the medial branch nerves is a well-established and effective treatment for lumbar facetogenic pain. While sarcopenia is associated with poor outcomes following epidural steroid injections and lumbar spine surgeries, its impact on clinical outcomes in patients undergoing RFA for facetogenic pain remains unexplored. This study aims to evaluate the influence of sarcopenia on treatment outcomes in this patient cohort. Methods: Patients were classified into sarcopenia (n = 35) and non-sarcopenia groups (n = 67) based on predefined psoas muscle index (PMI) thresholds. The primary outcomes included changes in back pain intensity and the proportion of responders at 1, 3, and 6 months following RFA. The secondary outcome was to identify demographic, clinical, and sarcopenia-related factors predictive of treatment response at each follow-up interval. Results: Both groups demonstrated statistically significant improvements in pain scores compared to baseline at all follow-up points. However, the median pain scores at 3 months post-RFA remained significantly higher in the sarcopenia group. Despite this, the proportion of responders did not differ significantly between the two groups at any time point. At 3 months, the absence of prior spinal surgery was identified as a significant predictor of treatment response. At 6 months, favorable outcomes were significantly associated with the absence of diabetes, no history of spinal surgery, and a higher PMI. Conclusions: Sarcopenia may influence the extent of pain improvement following medial branch nerve RFA. Additionally, patient-specific factors, such as diabetes, prior spinal surgery, and PMI, should be considered when predicting treatment outcomes.<\/jats:p>","DOI":"10.3390\/jpm15080344","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T13:11:11Z","timestamp":1754313071000},"page":"344","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of Sarcopenia on the Outcomes of Radiofrequency Ablation of Medial Branch Nerves for Lumbar Facet Arthropathy in Patients Aged 60 Years and Older: A Retrospective Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6811-7198","authenticated-orcid":false,"given":"Seung Hee","family":"Yoo","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2046-8690","authenticated-orcid":false,"given":"Won-Joong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"519","DOI":"10.36076\/ppj.2020\/23\/519","article-title":"Low Back Pain and Diagnostic Lumbar Facet Joint Nerve Blocks: Assessment of Prevalence, False-Positive Rates, and a Philosophical Paradigm Shift from an Acute to a Chronic Pain Model","volume":"23","author":"Manchikanti","year":"2020","journal-title":"Pain Physician"},{"key":"ref_2","first-page":"171","article-title":"Multivariable analysis of the relationship between pain referral patterns and the source of chronic low back pain","volume":"15","author":"Laplante","year":"2012","journal-title":"Pain Physician"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S129","DOI":"10.36076\/ppj.2020\/23\/S129","article-title":"Trends of Expenditures and Utilization of Facet Joint Interventions in Fee-For-Service (FFS) Medicare Population from 2009\u20132018","volume":"23","author":"Manchikanti","year":"2020","journal-title":"Pain Physician"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e53","DOI":"10.1056\/NEJMvcm2211108","article-title":"Medial Branch Blocks and Radiofrequency Ablation for Low Back Pain from Facet Joints","volume":"389","author":"Hao","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1213\/ANE.0000000000005054","article-title":"Waddell (Nonorganic) Signs and Their Association with Interventional Treatment Outcomes for Low Back Pain","volume":"132","author":"Cohen","year":"2021","journal-title":"Anesth. Analg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/01.ajp.0000210941.04182.ea","article-title":"Clinical predictors of success and failure for lumbar facet radiofrequency denervation","volume":"23","author":"Cohen","year":"2007","journal-title":"Clin. J. Pain."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2807","DOI":"10.2147\/JPR.S325665","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","journal-title":"J. Pain. Res."},{"key":"ref_8","first-page":"569","article-title":"Radiofrequency Denervation on Lumbar Facet Joint Pain in the Elderly: A Randomized Controlled Prospective Trial","volume":"25","author":"Chen","year":"2022","journal-title":"Pain Physician"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"E909","DOI":"10.36076\/ppj.2012\/15\/E909","article-title":"An update of the effectiveness of therapeutic lumbar facet joint interventions","volume":"15","author":"Falco","year":"2012","journal-title":"Pain Physician"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"229","DOI":"10.36076\/ppj.2007\/10\/229","article-title":"A systematic review of therapeutic facet joint interventions in chronic spinal pain","volume":"10","author":"Boswell","year":"2007","journal-title":"Pain Physician"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/ageing\/afz046","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.bja.2019.03.034","article-title":"Frailty assessment: From clinical to radiological tools","volume":"123","author":"Bentov","year":"2019","journal-title":"Br. J. Anaesth."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1093\/ageing\/afq034","article-title":"Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People","volume":"39","author":"Baeyens","year":"2010","journal-title":"Age Ageing"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1007\/s11605-015-2835-y","article-title":"Impact Total Psoas Volume on Short- and Long-Term Outcomes in Patients Undergoing Curative Resection for Pancreatic Adenocarcinoma: A New Tool to Assess Sarcopenia","volume":"19","author":"Amini","year":"2015","journal-title":"J. Gastrointest. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s00068-013-0313-3","article-title":"Psoas:lumbar vertebra index: Central sarcopenia independently predicts morbidity in elderly trauma patients","volume":"40","author":"Ebbeling","year":"2014","journal-title":"Eur. J. Trauma. Emerg. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1097\/BRS.0000000000004386","article-title":"Multifidus Sarcopenia Is Associated with Worse Patient-reported Outcomes Following Posterior Cervical Decompression and Fusion","volume":"47","author":"Pinter","year":"2022","journal-title":"Spine"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Shimizu, T., Miyake, M., Hori, S., Ichikawa, K., Omori, C., Iemura, Y., Owari, T., Itami, Y., Nakai, Y., and Anai, S. (2020). Clinical Impact of Sarcopenia and Inflammatory\/Nutritional Markers in Patients with Unresectable Metastatic Urothelial Carcinoma Treated with Pembrolizumab. Diagnostics, 10.","DOI":"10.3390\/diagnostics10050310"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e19059","DOI":"10.1097\/MD.0000000000019059","article-title":"Skeletal muscle mass predicts the outcome of nivolumab treatment for non-small cell lung cancer","volume":"99","author":"Tsukagoshi","year":"2020","journal-title":"Medicine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1159\/000480407","article-title":"Simple Age Specific Cutoff Value for Sarcopenia Evaluated by Computed Tomography","volume":"71","author":"Kim","year":"2017","journal-title":"Ann. Nutr. Metab."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Sim, J.H., Lee, S.H., Kim, J.W., Koh, W.U., Kim, H.T., Ro, Y.J., and Kim, H.J. (2021). Low Psoas Lumbar Vertebral Index Is Associated with Mortality after Hip Fracture Surgery in Elderly Patients: A Retrospective Analysis. J. Pers. Med., 11.","DOI":"10.3390\/jpm11070673"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"An, S.M., Chae, J.S., Lee, H.J., Cho, S., and Im, J. (2024). Association of Psoas: Lumbar Vertebral Index (PLVI) with Postherpetic Neuralgia in Patients Aged 60 and Older with Herpes Zoster. J. Clin. Med., 13.","DOI":"10.3390\/jcm13113100"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"358","DOI":"10.3344\/kjp.23092","article-title":"Association between fatty infiltration in the cervical multifidus and treatment response following cervical interlaminar epidural steroid injection","volume":"36","author":"Kwon","year":"2023","journal-title":"Korean J. Pain."},{"key":"ref_23","first-page":"E1105","article-title":"Influence of Handgrip Strength and Psoas Muscle Index on Analgesic Efficacy of Epidural Steroid Injection in Patients with Degenerative Lumbar Spinal Disease","volume":"25","author":"Kim","year":"2022","journal-title":"Pain Physician"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1111\/papr.13141","article-title":"Influence of cross-sectional area and fat infiltration of paraspinal muscles on analgesic efficacy of epidural steroid injection in elderly patients","volume":"22","author":"Kim","year":"2022","journal-title":"Pain. Pr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.afos.2018.02.003","article-title":"The impact of sarcopenia on the results of lumbar spinal surgery","volume":"4","author":"Inose","year":"2018","journal-title":"Osteoporos. Sarcopenia"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1097\/ALN.0b013e3181e33b02","article-title":"Diagnostic medial branch blocks before lumbar radiofrequency zygapophysial (facet) joint denervation: Benefit or burden?","volume":"113","author":"Mekhail","year":"2010","journal-title":"Anesthesiology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1136\/rapm-2022-103653","article-title":"Anatomical study of the medial branches of the lumbar dorsal rami: Implications for image-guided intervention","volume":"47","author":"Tran","year":"2022","journal-title":"Reg. Anesth. Pain. Med."},{"key":"ref_28","first-page":"475","article-title":"Radiofrequency denervation with or without addition of pentoxifylline or methylprednisolone for chronic lumbar zygapophysial joint pain","volume":"57","author":"Dobrogowski","year":"2005","journal-title":"Pharmacol. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jpain.2007.09.005","article-title":"Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations","volume":"9","author":"Dworkin","year":"2008","journal-title":"J. Pain."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Han, Y.A., Kwon, H.J., Lee, K., Son, M.G., Kim, H., Choi, S.S., Shin, J.W., and Kim, D.H. (2023). Impact of Sarcopenia on Percutaneous Epidural Balloon Neuroplasty in Patients with Lumbar Spinal Stenosis: A Retrospective Analysis. Medicina, 59.","DOI":"10.3390\/medicina59050847"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s00384-020-03799-1","article-title":"Low psoas muscle area is associated with postoperative complications in Crohn\u2019s disease","volume":"36","author":"Zager","year":"2021","journal-title":"Int. J. Color. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Kang, M., Kim, S.H., Jo, M., Jung, H.E., Bae, J., and Kim, H.J. (2023). Evaluation of Paraspinal Muscle Degeneration on Pain Relief after Percutaneous Epidural Adhesiolysis in Patients with Degenerative Lumbar Spinal Disease. Medicina, 59.","DOI":"10.3390\/medicina59061118"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1038\/nrrheum.2012.199","article-title":"Osteoarthritis of the spine: The facet joints","volume":"9","author":"Gellhorn","year":"2013","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"4990","DOI":"10.1007\/s00330-019-06047-5","article-title":"Facet arthropathy evaluation: CT or MRI?","volume":"29","author":"Berg","year":"2019","journal-title":"Eur. Radiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"357","DOI":"10.3340\/jkns.2015.58.4.357","article-title":"The Effects of Spinopelvic Parameters and Paraspinal Muscle Degeneration on S1 Screw Loosening","volume":"58","author":"Kim","year":"2015","journal-title":"J. Korean Neurosurg. Soc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.jocn.2024.06.022","article-title":"Effect of psoas muscle index on early postoperative outcomes in surgically treated spinal tumours in an Asian population","volume":"126","author":"Kumar","year":"2024","journal-title":"J. Clin. Neurosci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.1177\/21925682211072626","article-title":"Psoas Muscle Index as a Predictor of Perioperative Outcomes in Geriatric Patients Undergoing Spine Surgery","volume":"13","author":"Pernik","year":"2023","journal-title":"Glob. Spine J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.spinee.2019.08.012","article-title":"Sarcopenia, but not frailty, predicts early mortality and adverse events after emergent surgery for metastatic disease of the spine","volume":"20","author":"Versteeg","year":"2020","journal-title":"Spine J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2150","DOI":"10.1007\/s00586-015-4050-7","article-title":"Study investigating the role of skeletal muscle mass estimation in metastatic spinal cord compression","volume":"24","author":"Gakhar","year":"2015","journal-title":"Eur. Spine J."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Sun, K., Zhu, H., Huang, B., Li, J., Liu, G., Jiao, G., and Chen, G. (2024). MRI-based central sarcopenia negatively impacts the therapeutic effectiveness of single-segment lumbar fusion surgery in the elderly. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-55390-1"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Sun, K., Liu, J., Zhu, H., Wang, J., Wan, H., Huang, B., Zhang, Q., and Chen, G. (2024). Lower psoas mass indicates worse prognosis in percutaneous vertebroplasty-treated osteoporotic vertebral compression fracture. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-64626-z"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Ruffilli, A., Manzetti, M., Cerasoli, T., Barile, F., Viroli, G., Traversari, M., Salamanna, F., Fini, M., and Faldini, C. (2022). Osteopenia and Sarcopenia as Potential Risk Factors for Surgical Site Infection after Posterior Lumbar Fusion: A Retrospective Study. Microorganisms, 10.","DOI":"10.3390\/microorganisms10101905"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Ruffilli, A., Manzetti, M., Barile, F., Ialuna, M., Cerasoli, T., Viroli, G., Salamanna, F., Contartese, D., Giavaresi, G., and Faldini, C. (2023). Complications after Posterior Lumbar Fusion for Degenerative Disc Disease: Sarcopenia and Osteopenia as Independent Risk Factors for Infection and Proximal Junctional Disease. J. Clin. Med., 12.","DOI":"10.3390\/jcm12041387"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1111\/os.70006","article-title":"Impact of Paraspinal Sarcopenia on Clinical Outcomes in Intervertebral Disc Degeneration Patients Following Percutaneous Transforaminal Endoscopic Lumbar Discectomy","volume":"17","author":"Fang","year":"2025","journal-title":"Orthop. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e793","DOI":"10.3928\/01477447-20170531-05","article-title":"Correlation of the Features of the Lumbar Multifidus Muscle with Facet Joint Osteoarthritis","volume":"40","author":"Yu","year":"2017","journal-title":"Orthopedics"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2345","DOI":"10.1177\/21925682221082053","article-title":"A Comparative Analysis of Frailty, Disability, and Sarcopenia with Patient Characteristics and Outcomes in Adult Spinal Deformity Surgery","volume":"13","author":"Akbik","year":"2023","journal-title":"Glob. Spine J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.jocn.2019.03.015","article-title":"Sarcopenia does not affect clinical outcomes following lumbar fusion","volume":"64","author":"McKenzie","year":"2019","journal-title":"J. Clin. Neurosci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1016\/j.spinee.2015.03.039","article-title":"Fat infiltration of paraspinal muscles is associated with low back pain, disability, and structural abnormalities in community-based adults","volume":"15","author":"Teichtahl","year":"2015","journal-title":"Spine J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/BF01400651","article-title":"The lumbar and lumbosacral facet-syndrome. Diagnostic measures, surgical treatment and results in 119 patients","volume":"128","author":"Markwalder","year":"1994","journal-title":"Acta Neurochir."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"84","DOI":"10.4103\/0970-9185.173334","article-title":"No difference in pain reduction after epidural steroid injections in diabetic versus nondiabetic patients: A retrospective cohort study","volume":"32","author":"Wong","year":"2016","journal-title":"J. Anaesthesiol. Clin. Pharmacol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2160","DOI":"10.1007\/s00586-011-1891-6","article-title":"Factors determining the success of radiofrequency denervation in lumbar facet joint pain: A prospective study","volume":"20","author":"Streitberger","year":"2011","journal-title":"Eur. Spine J."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/S0140-6736(06)69251-9","article-title":"Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: A systematic review of cohort studies","volume":"368","author":"Montori","year":"2006","journal-title":"Lancet"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Wu, W.T., Lee, T.M., Han, D.S., and Chang, K.V. (2021). The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease-A Systematic Review and Meta-Analysis. J. Clin. Med.","DOI":"10.37766\/inplasy2020.12.0123"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s00586-007-0543-3","article-title":"Diagnosis and conservative management of degenerative lumbar spondylolisthesis","volume":"17","author":"Kalichman","year":"2008","journal-title":"Eur. Spine J."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/8\/344\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:20:52Z","timestamp":1760034052000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/8\/344"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,1]]},"references-count":54,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["jpm15080344"],"URL":"https:\/\/doi.org\/10.3390\/jpm15080344","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,1]]}}}