医学
骶髂关节
脉动式射频电磁波
Oswestry残疾指数
射频消融术
子群分析
腰痛
荟萃分析
内科学
外科
病理
止痛
烧蚀
替代医学
作者
Giuseppe Maccagnano,Giovanni Noia,Giuseppe D Cassano,Michele Coviello,Maria Concetta Meluzio,Giovanni Vicenti,Francesco Ciro Tamburrelli,Andrea Perna,Vito Pesce
出处
期刊:Journal of Neurosurgical Sciences
[Edizioni Minerva Medica]
日期:2022-11-01
卷期号:66 (6)
被引量:1
标识
DOI:10.23736/s0390-5616.22.05525-4
摘要
Chronic low back pain (LBP) can be caused by sacroiliac joint (SIJ) disease. Many conditions could cause SIJ dysfunction. The lateral branches of the L4-S3 dorsal rami are responsible for the primary innervation of the posterior SI joint. Radiofrequency (RF) denervation represent an emerging promising treatment for refractory sacroiliac joint pain. There are different types of RF denervation such as thermal or cooled. Use of irrigation cooled electrodes allows targeted tissues to reach the neuroablative temperatures slowly, preventing collateral damage of adjacent tissue.We conducted electronic database (PubMed, Medline, Cochrane and Google Scholar) research (time frame: January 1st, 2010 to May 31st, 2021) for clinical studies that had tested conventional radiofrequency (RFT) and cooled radiofrequency (RFC) to treat sacroiliac joint pain. These studies were evaluated according to Level of Evidence. Quantitative assessment of qualifying studies was done using the random effects model. We calculated the pooled size effect using standardized mean difference (SMD) as the main effect measure.We identified nine studies, with a total of 276 patients affected by sacroiliac joint pain and treated with radiofrequency. The analysis revealed a small and non-significant difference in pain reduction and an improvement in quality of life in RFT subgroup (Pain measured in Visual Analogic Scale: RFT subgroups SMD=-3.643 (95% CI -4.478, -2.807), RFC subgroup SMD=-3.285 (95% CI -4.428, -2.141), P=0.587; Quality of Life measured in Oswestry Disability Index: RFT subgroup SMD=-35.969 (95% CI -53.993%, -17.945%), RFC subgroup SMD=-20.589% (95% CI -33.424%. -7.754%), P=0.123). Publication bias was found in quality-of-life assessment due to the low number and high heterogeneity of studies. Two techniques showed no major complications.Current evidence indicates no statistical difference between two techniques examined. The literature is currently lacking, and well-constructed randomized clinical trials are necessary to evaluate this deficient aspect.
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