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Radiofrequency and pulsed radiofrequency treatment of chronic pain syndromes: the available evidence.
- Source :
-
Pain practice : the official journal of World Institute of Pain [Pain Pract] 2008 Sep-Oct; Vol. 8 (5), pp. 385-93. Date of Electronic Publication: 2008 Aug 19. - Publication Year :
- 2008
-
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.
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 1533-2500
- Volume :
- 8
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Pain practice : the official journal of World Institute of Pain
- Publication Type :
- Academic Journal
- Accession number :
- 18721175
- Full Text :
- https://doi.org/10.1111/j.1533-2500.2008.00227.x