1. Radiofrequency and pulsed radiofrequency treatment of chronic pain syndromes: the available evidence.
- Author
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van Boxem K, van Eerd M, Brinkhuizen T, Patijn J, van Kleef M, and van Zundert J
- Subjects
- Back Pain physiopathology, Chronic Disease therapy, Evidence-Based Medicine methods, Humans, Neck Pain physiopathology, Radiculopathy physiopathology, Sacroiliac Joint innervation, Sacroiliac Joint physiopathology, Sacroiliac Joint surgery, Spinal Diseases physiopathology, Spinal Nerve Roots physiopathology, Spinal Nerve Roots surgery, Treatment Outcome, Trigeminal Neuralgia physiopathology, Trigeminal Neuralgia surgery, Zygapophyseal Joint innervation, Zygapophyseal Joint physiopathology, Zygapophyseal Joint surgery, Back Pain surgery, Catheter Ablation statistics & numerical data, Neck Pain surgery, Radiculopathy surgery, Spinal Diseases surgery
- Abstract
There are currently 6 reviews on (pulsed) radiofrequency (RF) for the management of spinal pain. Two reviews on interventional pain management techniques in general also discuss RF. The outcomes of those reviews depend on the type of studies included and the opinion of the reviewers, which may result in different evidence levels. Radiofrequency denervation at the cervical and lumbar level has produced the most solid evidence. The differences in treatment outcome registered in the 5 randomized controlled trials (RCTs) regarding lumbar facet denervation can be attributed to differences in patient selection and/or inappropriate technique. There is not sufficient evidence supporting the use of RF facet denervation for the management of cervicogenic headache. The studies examining the management of cervical radicular pain suggest a comparable efficacy for RF and pulsed RF (PRF). The PRF treatment is supposed to be safer and therefore should be preferred. The superiority of RF treatment adjacent to the lumbar dorsal root ganglion for the management of lumbar radicular pain has not been demonstrated in an RCT. Information regarding RF treatment of sacroiliac joint pain is accumulating. No randomized sham-controlled trials on the value of RF treatment of the Gasserian ganglion for the management of idiopathic trigeminal neuralgia have been published. One RCT indicates superiority of RF over PRF for the management of idiopathic trigeminal neuralgia. Future research to confirm or deny the efficacy of (P)RF should be conducted in carefully selected patient populations. The tests used for patient inclusion in such a trial could potentially help the clinician in selecting patients for this type of treatment. The value of PRF treatment of the peripheral nerves also needs to be confirmed in well-designed trials.
- Published
- 2008
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