Efficacy and safety of pulsed radiofrequency as a method of dorsal root ganglia stimulation for treatment of non-neuropathic pain: a systematic review
Abstract Background We systematically reviewed the evidence on the efficacy and safety of dorsal root ganglion (DRG) targeted pulsed radiofrequency (PRF) versus any comparator for treatment of non-neuropathic pain. Methods We searched MEDLINE, CINAHL, Embase, PsycINFO, clinicaltrials.gov and WHO cli...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Anesthesiology |
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| Online Access: | http://link.springer.com/article/10.1186/s12871-020-01023-9 |
| _version_ | 1828382014784405504 |
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| author | Ivana Vuka Svjetlana Došenović Tihana Marciuš Lejla Ferhatović Hamzić Katarina Vučić Damir Sapunar Livia Puljak |
| author_facet | Ivana Vuka Svjetlana Došenović Tihana Marciuš Lejla Ferhatović Hamzić Katarina Vučić Damir Sapunar Livia Puljak |
| author_sort | Ivana Vuka |
| collection | DOAJ |
| description | Abstract Background We systematically reviewed the evidence on the efficacy and safety of dorsal root ganglion (DRG) targeted pulsed radiofrequency (PRF) versus any comparator for treatment of non-neuropathic pain. Methods We searched MEDLINE, CINAHL, Embase, PsycINFO, clinicaltrials.gov and WHO clinical trial register until January 8, 2019. All study designs were eligible. Two authors independently conducted literature screening. Primary outcomes were pain intensity and serious adverse events (SAEs). Secondary outcomes were any other pain-related outcome and any other safety outcome that was reported. We assessed the risk of bias using the Cochrane tool and Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I). We conducted narrative evidence synthesis and assessed the conclusiveness of included studies regarding efficacy and safety. Results We included 17 studies with 599 participants, which analyzed various pain syndromes. Two studies were randomized controlled trials; both included participants with low back pain (LBP). Non-randomized studies included patients with the following indications: LBP, postsurgical pain, pain associated with herpes zoster, cervicogenic headache, complex regional pain syndrome type 1, intractable vertebral metastatic pain, chronic scrotal and inguinal pain, occipital radiating pain in rheumatoid arthritis and chronic migraine. In these studies, the PRF was usually initiated after other treatments have failed. Eleven studies had positive conclusive statements (11/17) about efficacy; the remaining had positive inconclusive statements. Only three studies provided conclusiveness of evidence statements regarding safety – two indicated that the evidence was positive conclusive, and one positive inconclusive. The risk of bias was predominantly unclear in randomized and serious in non-randomized studies. Conclusion Poor quality and few participants characterize evidence about benefits and harms of DRG PRF in patients with non-neuropathic pain. Results from available studies should only be considered preliminary. Not all studies have reported data regarding the safety of the intervention, but those that did, indicate that the intervention is relatively safe. As the procedure is non-destructive and early results are promising, further comparative studies about PRF in non-neuropathic pain syndromes would be welcomed. |
| first_indexed | 2024-12-10T04:25:09Z |
| format | Article |
| id | doaj.art-b26e146ccc484f338a3328960200bf34 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-10T04:25:09Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-b26e146ccc484f338a3328960200bf342022-12-22T02:02:18ZengBMCBMC Anesthesiology1471-22532020-05-0120112110.1186/s12871-020-01023-9Efficacy and safety of pulsed radiofrequency as a method of dorsal root ganglia stimulation for treatment of non-neuropathic pain: a systematic reviewIvana Vuka0Svjetlana Došenović1Tihana Marciuš2Lejla Ferhatović Hamzić3Katarina Vučić4Damir Sapunar5Livia Puljak6Laboratory for Pain Research, University of Split School of MedicineDepartment of Anesthesiology, Reanimatology and Intensive Care, University Hospital SplitLaboratory for Pain Research, University of Split School of MedicineCenter for Translational and Clinical Research, Department of Proteomics, University of Zagreb School of MedicineDepartment for Safety and Efficacy Assessment of Medicinal Products, Agency for Medicinal Products and Medical DevicesLaboratory for Pain Research, University of Split School of MedicineCenter for Evidence-Based Medicine and Health Care, Catholic University of CroatiaAbstract Background We systematically reviewed the evidence on the efficacy and safety of dorsal root ganglion (DRG) targeted pulsed radiofrequency (PRF) versus any comparator for treatment of non-neuropathic pain. Methods We searched MEDLINE, CINAHL, Embase, PsycINFO, clinicaltrials.gov and WHO clinical trial register until January 8, 2019. All study designs were eligible. Two authors independently conducted literature screening. Primary outcomes were pain intensity and serious adverse events (SAEs). Secondary outcomes were any other pain-related outcome and any other safety outcome that was reported. We assessed the risk of bias using the Cochrane tool and Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I). We conducted narrative evidence synthesis and assessed the conclusiveness of included studies regarding efficacy and safety. Results We included 17 studies with 599 participants, which analyzed various pain syndromes. Two studies were randomized controlled trials; both included participants with low back pain (LBP). Non-randomized studies included patients with the following indications: LBP, postsurgical pain, pain associated with herpes zoster, cervicogenic headache, complex regional pain syndrome type 1, intractable vertebral metastatic pain, chronic scrotal and inguinal pain, occipital radiating pain in rheumatoid arthritis and chronic migraine. In these studies, the PRF was usually initiated after other treatments have failed. Eleven studies had positive conclusive statements (11/17) about efficacy; the remaining had positive inconclusive statements. Only three studies provided conclusiveness of evidence statements regarding safety – two indicated that the evidence was positive conclusive, and one positive inconclusive. The risk of bias was predominantly unclear in randomized and serious in non-randomized studies. Conclusion Poor quality and few participants characterize evidence about benefits and harms of DRG PRF in patients with non-neuropathic pain. Results from available studies should only be considered preliminary. Not all studies have reported data regarding the safety of the intervention, but those that did, indicate that the intervention is relatively safe. As the procedure is non-destructive and early results are promising, further comparative studies about PRF in non-neuropathic pain syndromes would be welcomed.http://link.springer.com/article/10.1186/s12871-020-01023-9Chronic painNon-neuropathic painPulsed radiofrequencyDorsal root ganglion |
| spellingShingle | Ivana Vuka Svjetlana Došenović Tihana Marciuš Lejla Ferhatović Hamzić Katarina Vučić Damir Sapunar Livia Puljak Efficacy and safety of pulsed radiofrequency as a method of dorsal root ganglia stimulation for treatment of non-neuropathic pain: a systematic review BMC Anesthesiology Chronic pain Non-neuropathic pain Pulsed radiofrequency Dorsal root ganglion |
| title | Efficacy and safety of pulsed radiofrequency as a method of dorsal root ganglia stimulation for treatment of non-neuropathic pain: a systematic review |
| title_full | Efficacy and safety of pulsed radiofrequency as a method of dorsal root ganglia stimulation for treatment of non-neuropathic pain: a systematic review |
| title_fullStr | Efficacy and safety of pulsed radiofrequency as a method of dorsal root ganglia stimulation for treatment of non-neuropathic pain: a systematic review |
| title_full_unstemmed | Efficacy and safety of pulsed radiofrequency as a method of dorsal root ganglia stimulation for treatment of non-neuropathic pain: a systematic review |
| title_short | Efficacy and safety of pulsed radiofrequency as a method of dorsal root ganglia stimulation for treatment of non-neuropathic pain: a systematic review |
| title_sort | efficacy and safety of pulsed radiofrequency as a method of dorsal root ganglia stimulation for treatment of non neuropathic pain a systematic review |
| topic | Chronic pain Non-neuropathic pain Pulsed radiofrequency Dorsal root ganglion |
| url | http://link.springer.com/article/10.1186/s12871-020-01023-9 |
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