Radiofrequency denervation for neck and back pain

Abstract

The selected trials provide limited evidence that radiofrequency denervation offers short-term relief for chronic neck pain of zygapophyseal joint origin and for chronic cervicobrachial pain; conflicting evidence on the short-term effect of radiofrequency lesioning on pain and disability in chronic low-back pain of zygapophyseal joint origin; and limited evidence that intradiscal radiofrequency thermocoagulation is not effective for chronic discogenic low-back pain. There is a need for further high-quality RCTs with larger patient samples and data on long-term effects, for which current evidence is inconclusive. Furthermore, RCTs are needed in non-spinal indications where radiofrequency denervation is currently used without any scientific evidence.

Chronic refractory myofascial pain and denervation supersensitivity as global public health disease

“…Conflicting evidence exists on the short-term effect of radiofrequency lesioning in chronic LBP and disability of zygapophyseal origin. Intradiscal radiofrequency thermocoagulation is not effective for chronic discogenic LBP 45…”

Chronic refractory myofascial pain and denervation supersensitivity as global public health disease

“…Conflicting evidence exists on the short-term effect of radiofrequency lesioning in chronic LBP and disability of zygapophyseal origin. Intradiscal radiofrequency thermocoagulation is not effective for chronic discogenic LBP 45…”

Pain-Administrable Neuron Electrode with Wireless Energy Transmission: Architecture Design and Prototyping

“…Electrical stimulation or heated energy was generally used to act on neurons in the spinal cord to block or interfere pain signaling to the brain. The pain signal transmission was generally prevented by the conventional continuous radiofrequency (CRF), which would generate a high temperature reaching 70-85 • C on the electrode tip to destroy the neural transmission and achieve pain relief [14][15][16][17].…”

“…Therefore, the neurosurgeons examine the exact sensory neuron location assisted by an in vitro monitor system and patients' self-feeling, and decide the sites that need electrode stimuli. Due to the conventional electrode design without a fixing anchor on the electrode tip, the stimulus would affect a large area accompanied with significant inevitable side effects [14][15][16][17]. When the therapeutic effects diminished, doctors generally increased the stimulatory dose to compensate for the lower therapeutic efficacy, which would increase the risk of safety concerns.…”

Current Concepts of Neurolysis and Clinical Applications.

“…Niemisto, et al performed a Cochrane Database review of radiofrequency for neck and back pain. [15] They found limited evidence that radiofrequency was effective for short-term relief of cervical pain. There was conflicting evidence from relief of pain from lumbar facet joint origin and limited evidence that IDET was not effective for discogenic low-back pain.…”

Chronic refractory myofascial pain and denervation supersensitivity as global public health disease

“…Conflicting evidence exists on the short-term effect of radiofrequency lesioning in chronic LBP and disability of zygapophyseal origin. Intradiscal radiofrequency thermocoagulation is not effective for chronic discogenic LBP 45…”

Pain-Administrable Neuron Electrode with Wireless Energy Transmission: Architecture Design and Prototyping

“…Electrical stimulation or heated energy was generally used to act on neurons in the spinal cord to block or interfere pain signaling to the brain. The pain signal transmission was generally prevented by the conventional continuous radiofrequency (CRF), which would generate a high temperature reaching 70-85 • C on the electrode tip to destroy the neural transmission and achieve pain relief [14][15][16][17].…”

“…Therefore, the neurosurgeons examine the exact sensory neuron location assisted by an in vitro monitor system and patients' self-feeling, and decide the sites that need electrode stimuli. Due to the conventional electrode design without a fixing anchor on the electrode tip, the stimulus would affect a large area accompanied with significant inevitable side effects [14][15][16][17]. When the therapeutic effects diminished, doctors generally increased the stimulatory dose to compensate for the lower therapeutic efficacy, which would increase the risk of safety concerns.…”

Current Concepts of Neurolysis and Clinical Applications.

“…Niemisto, et al performed a Cochrane Database review of radiofrequency for neck and back pain. [15] They found limited evidence that radiofrequency was effective for short-term relief of cervical pain. There was conflicting evidence from relief of pain from lumbar facet joint origin and limited evidence that IDET was not effective for discogenic low-back pain.…”

Chronic refractory myofascial pain and denervation supersensitivity as global public health disease

“…Conflicting evidence exists on the short-term effect of radiofrequency lesioning in chronic LBP and disability of zygapophyseal origin. Intradiscal radiofrequency thermocoagulation is not effective for chronic discogenic LBP 45…”

Pain-Administrable Neuron Electrode with Wireless Energy Transmission: Architecture Design and Prototyping

“…Electrical stimulation or heated energy was generally used to act on neurons in the spinal cord to block or interfere pain signaling to the brain. The pain signal transmission was generally prevented by the conventional continuous radiofrequency (CRF), which would generate a high temperature reaching 70-85 • C on the electrode tip to destroy the neural transmission and achieve pain relief [14][15][16][17].…”

“…Therefore, the neurosurgeons examine the exact sensory neuron location assisted by an in vitro monitor system and patients' self-feeling, and decide the sites that need electrode stimuli. Due to the conventional electrode design without a fixing anchor on the electrode tip, the stimulus would affect a large area accompanied with significant inevitable side effects [14][15][16][17]. When the therapeutic effects diminished, doctors generally increased the stimulatory dose to compensate for the lower therapeutic efficacy, which would increase the risk of safety concerns.…”

Current Concepts of Neurolysis and Clinical Applications.

“…Niemisto, et al performed a Cochrane Database review of radiofrequency for neck and back pain. [15] They found limited evidence that radiofrequency was effective for short-term relief of cervical pain. There was conflicting evidence from relief of pain from lumbar facet joint origin and limited evidence that IDET was not effective for discogenic low-back pain.…”