Purpose of Technology: Radiofrequency ablation (RFA) is a percutaneous treatment for chronic low back pain (LBP) using radiowave-induced heat to create a lesion in a spinal sensory nerve. Following a diagnostic blockade to target the affected nerve(s), radiofrequency (RF) current is applied in a pulsed or continuous manner for several minutes via a needle electrode to denervate the targeted nerve(s) under image guidance. The goal of RFA is to relieve pain by interrupting the transmission of pain signals from the sensory nerves to the brain.

Controversy: The effects of RF neurotomy are not permanent, and may last from 6 months to 1 year or longer. RF neurotomy is thought to temporarily relieve pain by denaturing axons within a target nerve or nerves. If pain recurs upon axonal regeneration, additional pain interventions may be required. Some studies suggest that RFA may have a placebo effect.

Relevant Questions:

  • For patients with chronic LBP, are nonpulsed and pulsed RFA effective for alleviating pain, improving function, and improving quality of life?

  • Are both nonpulsed and pulsed RFA safe for patients with chronic LBP?

  • How do nonpulsed and pulsed RFA compare with sham therapy, steroid injections, and other alternatives for relief of pain and symptoms related to chronic nonspecific LBP?

  • Have definitive patient selection criteria been established for percutaneous RFA for LBP?

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