• Leena Niemistö, Eija Kalso, Antti Malmivaara, Seppo Seitsalo, Heikki Hurri, and Cochrane Collaboration Back Review Group.
• Orton Orthopaedic Hospital, Invalid Foundation, Helsinki, Finland. leena.niemisto@invalidisaatio.fi
• Spine. 2003 Aug 15; 28 (16): 1877-88.

Study DesignSystematic review.ObjectiveTo assess the effectiveness of radiofrequency denervation for the treatment of musculoskeletal pain disorders.Summary Of Background DataThere is a lack of effective treatment for chronic zygapophysial joint pain and discogenic pain. Radiofrequency denervation appears to be an emerging technology, with substantial variation in its use.MethodsOriginal articles for this review were identified by electronically searching MEDLINE, PsycLIT, EMBASE, and the Cochrane Library to February 2002, hand-screening references, and consulting experts in the field. Two reviewers selected the randomized controlled trials that met the inclusion criteria, extracted the data, and assessed the main results and methodologic quality of the selected trials. Finally, qualitative analysis was conducted to evaluate the level of scientific evidence.ResultsOf seven relevant randomized controlled trials, six were considered to be high quality. The selected trials included 275 randomized patients, 141 of whom received active treatment. One study examined cervical zygapophysial joint pain; two, cervicobrachial pain; three, lumbar zygapophysial joint pain; and one, discogenic low back pain. The sample sizes were small, follow-up times short, and there were deficiencies noted in patient selection, outcome assessments, and statistical analyses.ConclusionsThere is limited evidence that radiofrequency denervation offers short-term relief for chronic neck pain of zygapophysial joint origin and for chronic cervicobrachial pain, and conflicting evidence for its effectiveness for lumbar zygapophysial joint pain. There is limited evidence suggesting that intradiscal radiofrequency may not be effective in relieving discogenic low back pain. Further high-quality randomized controlled trials are needed, with larger patient samples and data on long-term effects, for which current evidence is inconclusive.

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