Radiofrequency neurotomy is a pain intervention procedure designed to coagulate nerves that innervate a specific area of spinal vertebrae known as the facet joint. Despite moderate to strong research support for the efficacy of radiofrequency neurotomy to improve short-term subjective pain levels, much of the literature to date has used strict selection criteria and has not focused on functional and quality of life outcomes. Moreover, few studies have examined outcomes in worker's compensation patients or considered biopsychosocial predictive variables for the procedure. The current study aimed to characterize injured workers who have undergone radiofrequency neurotomy across a number of pre and post-procedural variables, evaluate multidimensional functional and quality of life outcomes, and examine biopsychosocial variables predictive of success and failure in this sample. The current study comprised 101 injured workers who had undergone at least one radiofrequency neurotomy of the spine (cervical, thoracic, or lumbar) in the past 11 years. Participants were solicited through the Worker's Compensation Fund of Utah computerized database. Employing a retrospective cohort design, patients' medical charts were reviewed and various preprocedural variables were coded for analysis including age at the time of the first neurotomy, history of depression, lawyer involvement in the claim, prior back and neck surgical history, and quantity of other compensation claims. Of the total sample, 56 patients (55.4%) were contacted and completed outcome surveys that assessed patient satisfaction, functional impairment, disability status, pain catastrophization, and general physical and mental health functioning. Findings revealed a moderate proportion of patients with total disability (40%), poor back/neck specific functioning (63%), and dissatisfaction with their current back/neck condition (75%). A multivariate regression model was consistently predictive of patient outcomes. Specifically, litigation status was a robust predictor of multidimensional outcomes, while depression and age retained slightly less predictive power. Results of descriptive, correlational, and regression analyses are compared to existing data for radiofrequency neurotomy and other spine procedures with similar populations. Limitations of the study are discussed, such as the retrospective design, lack of matched controls, and small sample size.

Back pain is one of the most expensive medical conditions to treat. There has been a great deal of research showing that back pain surgery is expensive, but less is known about the costs of less-invasive spine procedures such as radiofrequency neurotomy. Radiofrequency neurotomy is used to treat facet joint pain and typically offers temporary pain relief by coagulating the affected nerve with radiofrequency waves to block pain messages from reaching the brain. This study aimed to document the costs of radiofrequency neurotomy in a group of participants who received the procedure through the Workers’ Compensation Fund of Utah (WCFU). Another goal of the study was to determine if any biopsychosocial variables of participants predicted costs. Biopsychosocial variables include biological (e.g., age), psychological (e.g., depression), and social (e.g., hiring a lawyer) characteristics about participants. Costs and characteristics were collected from participant medical records. Compensation and medical costs were collected; compensation costs were wage payouts as a result of an on-the-job injury, and medical costs were direct medical costs. Both compensation and medical costs were substantial and similar to other more invasive procedures. Furthermore, three biopsychosocial characteristics predicted high costs. A high number of prior back and neck surgery and lawyer involvement predicted high compensation costs. Those same variables plus history of depression predicted high medical costs. This was the first known study to document medical and compensation costs associated with spinal radiofrequency neurotomy. The findings add to the line of research suggesting that a biopsychosocial framework can be used to predict costs in spine care. Discovering participant characteristics that may predict high costs can inform policylevel decisions for insurers, and can be used by medical providers to influence patient care decisions. More research on the presurgical variables may lead to interventions at the patient level that can reduce high cost outcomes which could benefit both patients and payers.