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Comparative efficacy of radiofrequency denervation in chronic low back pain: A systematic review and network meta-analysis

BACKGROUND: Facet joint pain is a common cause of chronic low back pain (CLBP). Radiofrequency (RF) denervation is an effective treatment option. PURPOSE: A systematic review and network meta-analysis (NMA) was performed to evaluate and compare the efficacy and effectiveness of different RF denervat...

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Autores principales: Li, Han, An, Junyan, Zhang, Jun, Kong, Weijian, Yun, Zhihe, Yu, Tong, Nie, Xinyu, Liu, Qinyi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9388860/
https://www.ncbi.nlm.nih.gov/pubmed/35990102
http://dx.doi.org/10.3389/fsurg.2022.899538
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author Li, Han
An, Junyan
Zhang, Jun
Kong, Weijian
Yun, Zhihe
Yu, Tong
Nie, Xinyu
Liu, Qinyi
author_facet Li, Han
An, Junyan
Zhang, Jun
Kong, Weijian
Yun, Zhihe
Yu, Tong
Nie, Xinyu
Liu, Qinyi
author_sort Li, Han
collection PubMed
description BACKGROUND: Facet joint pain is a common cause of chronic low back pain (CLBP). Radiofrequency (RF) denervation is an effective treatment option. PURPOSE: A systematic review and network meta-analysis (NMA) was performed to evaluate and compare the efficacy and effectiveness of different RF denervation treatments in managing facet joint-derived CLBP. METHODS: The Cochrane Library, Embase, PubMed, and China Biology Medicine were searched to identify eligible randomized controlled trials (RCTs) from January 1966 through December 2021. Interventions included conventional radiofrequency denervation (CRF), pulsed radiofrequency denervation (PRF), pulsed radiofrequency treatment of the dorsal root ganglia (PRF-DRG), radiofrequency facet capsule denervation (RF-FC), and radiofrequency ablation under endoscopic guidance (ERFA). The outcome was the mean change in visual analog scale (VAS) score from baseline. A random-effects NMA was used to compare the pain relief effects of the interventions over the short term (≤6 months) and long term (12 months). The rank of effect estimation for each intervention was computed using the surface under the cumulative ranking curve. RESULTS: A total of 10 RCTs with 715 patients met the inclusion criteria. Moderate evidence indicated that CRF denervation had a greater effect on pain relief than sham control in the short term (standardized mean difference (SMD) −1.58, 95% confidence intervals (CI) −2.98 to −0.18) and the long term (SMD −4.90, 95% CI, −5.86 to −3.94). Fair evidence indicated that PRF denervation was more effective than sham control for pain over the long term (SMD −1.30, 95% CI, −2.17 to −0.43). Fair evidence showed that ERFA denervation was more effective for pain relief than sham control in the short term (SMD −3.07, 95% CI, −5.81 to −0.32) and the long term (SMD −4.00, 95% CI, −4.95 to −3.05). Fair evidence showed that RF-FC denervation was more effective for pain relief than sham control in the long term (SMD −1.11, 95% CI, −2.07 to −0.15). A fair level of evidence indicated that PRF-DRG denervation was more effective for pain relief than sham control in the short term (SMD −5.34, 95% CI, −8.30 to −2.39). CONCLUSION: RF is an effective option for patients diagnosed with facet joint-derived CLBP. Systematic Review Registration: Identifier: CRD42022298238.
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spelling pubmed-93888602022-08-20 Comparative efficacy of radiofrequency denervation in chronic low back pain: A systematic review and network meta-analysis Li, Han An, Junyan Zhang, Jun Kong, Weijian Yun, Zhihe Yu, Tong Nie, Xinyu Liu, Qinyi Front Surg Surgery BACKGROUND: Facet joint pain is a common cause of chronic low back pain (CLBP). Radiofrequency (RF) denervation is an effective treatment option. PURPOSE: A systematic review and network meta-analysis (NMA) was performed to evaluate and compare the efficacy and effectiveness of different RF denervation treatments in managing facet joint-derived CLBP. METHODS: The Cochrane Library, Embase, PubMed, and China Biology Medicine were searched to identify eligible randomized controlled trials (RCTs) from January 1966 through December 2021. Interventions included conventional radiofrequency denervation (CRF), pulsed radiofrequency denervation (PRF), pulsed radiofrequency treatment of the dorsal root ganglia (PRF-DRG), radiofrequency facet capsule denervation (RF-FC), and radiofrequency ablation under endoscopic guidance (ERFA). The outcome was the mean change in visual analog scale (VAS) score from baseline. A random-effects NMA was used to compare the pain relief effects of the interventions over the short term (≤6 months) and long term (12 months). The rank of effect estimation for each intervention was computed using the surface under the cumulative ranking curve. RESULTS: A total of 10 RCTs with 715 patients met the inclusion criteria. Moderate evidence indicated that CRF denervation had a greater effect on pain relief than sham control in the short term (standardized mean difference (SMD) −1.58, 95% confidence intervals (CI) −2.98 to −0.18) and the long term (SMD −4.90, 95% CI, −5.86 to −3.94). Fair evidence indicated that PRF denervation was more effective than sham control for pain over the long term (SMD −1.30, 95% CI, −2.17 to −0.43). Fair evidence showed that ERFA denervation was more effective for pain relief than sham control in the short term (SMD −3.07, 95% CI, −5.81 to −0.32) and the long term (SMD −4.00, 95% CI, −4.95 to −3.05). Fair evidence showed that RF-FC denervation was more effective for pain relief than sham control in the long term (SMD −1.11, 95% CI, −2.07 to −0.15). A fair level of evidence indicated that PRF-DRG denervation was more effective for pain relief than sham control in the short term (SMD −5.34, 95% CI, −8.30 to −2.39). CONCLUSION: RF is an effective option for patients diagnosed with facet joint-derived CLBP. Systematic Review Registration: Identifier: CRD42022298238. Frontiers Media S.A. 2022-08-05 /pmc/articles/PMC9388860/ /pubmed/35990102 http://dx.doi.org/10.3389/fsurg.2022.899538 Text en © 2022 Li, An, Zhang, Kong, Yun, Yu, Nie and Liu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Li, Han
An, Junyan
Zhang, Jun
Kong, Weijian
Yun, Zhihe
Yu, Tong
Nie, Xinyu
Liu, Qinyi
Comparative efficacy of radiofrequency denervation in chronic low back pain: A systematic review and network meta-analysis
title Comparative efficacy of radiofrequency denervation in chronic low back pain: A systematic review and network meta-analysis
title_full Comparative efficacy of radiofrequency denervation in chronic low back pain: A systematic review and network meta-analysis
title_fullStr Comparative efficacy of radiofrequency denervation in chronic low back pain: A systematic review and network meta-analysis
title_full_unstemmed Comparative efficacy of radiofrequency denervation in chronic low back pain: A systematic review and network meta-analysis
title_short Comparative efficacy of radiofrequency denervation in chronic low back pain: A systematic review and network meta-analysis
title_sort comparative efficacy of radiofrequency denervation in chronic low back pain: a systematic review and network meta-analysis
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9388860/
https://www.ncbi.nlm.nih.gov/pubmed/35990102
http://dx.doi.org/10.3389/fsurg.2022.899538
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