The Effectiveness of Intraosseous Basivertebral Nerve Radiofrequency Neurotomy for the Treatment of Chronic Low Back Pain in Patients with Modic Changes: A Systematic Review.
Pain Med
; 22(5): 1039-1054, 2021 05 21.
Article
em En
| MEDLINE
| ID: mdl-33544851
ABSTRACT
OBJECTIVE:
Determine the effectiveness of intraosseous basivertebral nerve radiofrequency neurotomy for the treatment of chronic low back pain with type 1 or 2 Modic changes.DESIGN:
Systematic review. POPULATION Persons aged ≥18 years with chronic low back pain with type 1 or 2 Modic changes. INTERVENTION Intraosseous basivertebral nerve radiofrequency neurotomy. COMPARISON Sham, placebo procedure, active standard care treatment, or none.OUTCOMES:
The primary outcome of interest was the proportion of individuals with ≥50% pain reduction. Secondary outcomes included ≥10-point improvement in function as measured by Oswestry Disability Index as well as ≥2-point reduction in pain score on the Visual Analog Scale or Numeric Rating Scale, and decreased use of pain medication.METHODS:
Three reviewers independently assessed publications before May 15, 2020, in MEDLINE and Embase and the quality of evidence was evaluated using the Grades of Recommendation, Assessment, Development, and Evaluation framework.RESULTS:
Of the 725 publications screened, seven publications with 321 participants were ultimately included. The reported 3-month success rate for ≥50% pain reduction ranged from 45% to 63%. Rates of functional improvement (≥10-point Oswestry Disability Index improvement threshold) ranged from 75% to 93%. For comparison to sham treatment, the relative risk of treatment success defined by ≥50% pain reduction and ≥10-point Oswestry Disability Index improvement was 1.25 (95% confidence interval [CI] .88-1.77) and 1.38 (95% CI 1.10-1.73), respectively. For comparison to continued standard care treatment the relative risk of treatment success defined by ≥50% pain reduction and ≥10-point Oswestry Disability Index improvement was 4.16 (95% CI 2.12-8.14) and 2.32 (95% CI 1.52-3.55), respectively.CONCLUSIONS:
There is moderate-quality evidence that suggests this procedure is effective in reducing pain and disability in patients with chronic low back pain who are selected based on type 1 or 2 Modic changes, among other inclusion and exclusion criteria used in the published literature to date. Success of the procedure appears to be dependent on effective targeting of the BVN. Non-industry funded high-quality, large prospective studies are needed to confirm these findings.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Dor Lombar
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Dor Crônica
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Guideline
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Observational_studies
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Systematic_reviews
Limite:
Adolescent
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Adult
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Humans
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article