• Leili Shahgholi, Nicole Ortiz, Tahereh Naeimi, Raymon Dhall, Mohammad Zaidi, Bryce Liu, Chong Kim, Timothy Deer, Alan D Kaye, and Sayed E Wahezi.
• Department of Physical Medicine and Rehabilitation, Burke Rehabilitation Hospital, White Plains, NY.
• Pain Physician. 2023 Nov 1; 26 (7): 569574569-574.

BackgroundRadiofrequency ablation (RFA) is a common treatment in which radiofrequency (RF) is used to heat neural tissue and reduce pain. The impact of adipose content in tissue on the lesion size may impact efficacy, and to date, there is little, if any, data comparing its influence on RFA.ObjectivesWe evaluated the influence of adipose tissue on RF lesion size.Study DesignControlled, ex vivo study.SettingAcademic institution in a procedural setting.MethodsRF lesions were created using 20-G 10-mm protruding electrode (PE) needles inserted into unbrined chicken breasts and thighs at 21°C. RF current was applied for 90 seconds at 80°C. Chicken breasts were used as the control group and chicken thighs were used as the high adipose variant. Four different groups were examined: 1- Standard 20 g RFA needle, 2- 20 g RFA PE needle, 3- Standard RFA needle with lidocaine 2% injectate, and 4- Standard RFA needle with iohexol 240 mg injectate. There were 12 lesions performed in each group; length, width, and depth were measured.ResultsThe control group had significantly deeper lesions in all 4 cohorts. Lesions' lengths were smaller in the fat-rich group. The control and PE cohorts showed a significant difference in width between the 2 fat-rich and nonfatty groups.LimitationsRadiofrequency ablation was performed at room temperature and not heated to physiological temperature. This was an ex vivo study, thus factors of human anatomy and physiology could not be evaluated.ConclusionsAdipose tissue content was inversely related to lesion size in all samples. This factor should be considered when assessing methods of enhancing lesion size in human models.

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