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24th Annual Pain Medicine Meeting 2025
November 13-15, 2025| JW Marriott Austin, Austin, Texas
2177597
Evidence of Multifidus Changes Post-Lumbar Radiofrequency Ablation: A Narrative Review
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Scientific Abstracts > Emerging Technology
Evidence of Multifidus Changes Post-Lumbar Radiofrequency Ablation: A Narrative Review
Abigail Joy Garcia, DO, David W. Lee, MD, Logan Leavitt, DO, & Vinicius Tieppo Francio, MD
BACKGROUND
•Among the multiple etiologies of chronic low back pain (CLBP), facet joint-mediated pain is notably prevalent.1
•The lumbar facet joints receive their primary sensation innervation from the lumbar medial branch nerves (LMBN). However, this nerve also provides motor innervation to the multifidus.
•Lumbar medial branch radiofrequency ablation (LRFA) remains a widely used interventional treatment for facetogenic CLBP.2
•A Cochrane review found high quality evidence that LRFAs provide pain relief; however, there is lacking evidence that it improves function.3
•Because of the mutual innervation of the LMBN to both the facet joint and multifidus, there is concern for unintended multifidus denervation and subsequent multifidus dysfunction and atrophy.4
•Here, we present a narrative review of the available data on post-LRFA multifidus changes.
GOALS
•Synthesize existing evidence on multifidus atrophy and dysfunction following LRFA
•Discuss the clinical relevance of these findings
•Identify possible need for further research on sequelae of LRFA
METHODS
•A comprehensive literature search was conducted across Cochrane Library, Web of Science Core Collection, Scopus, PubMed, and MEDLINE using the search terms “multifidus” AND “radiofrequency.”
•Inclusion criteria and a PRISMA diagram is provided in Table 1 and Figure 1.
RESULTS and DISCUSSION
•Included articles are arranged by quality of research and discussed based on conclusions and limitations in Figure 2.
CONCLUSION
•The variability in study design, measurement parameters, sample size, methods, and conflicting results leaves the nature and extent of post-LRFA multifidus atrophy unresolved.
•The scarcity of high-quality research and the lack of standardized methods to evaluate post-procedural structural and functional changes underscore the need for well-designed prospective studies.