Efficacy of radiofrequency ablation in the treatment of discogenic low back pain: a meta-analysis.

BACKGROUND

Discogenic low back pain (DLBP) affects people's quality of life. In recent years, the number of studies on the treatment of DLBP with radiofrequency ablation (RFA) has increased, but a systematic summarization is lacking. In this study, all the published research on the treatment of DLBP with RFA was analysed and the evidence-based medical evidence of the efficacy of this physical interventional treatment for DLBP was summarized.

METHODS

Articles published from the establishment of the databases to February 2025 were retrieved from PubMed, Embase, ClinicalTrial, Web of Science, Ovid, and the Cochrane Library. After all studies on the treatment of DLBP with RFA were strictly screened, a meta-analysis was conducted.

RESULTS

Eleven studies, including eight randomized controlled trials (RCTs) and three prospective single-arm trials (PSATs), demonstrated that RFA significantly alleviated pain on the visual analogue scale (VAS), as shown by standardized mean difference (SMD) (SMD: 1 week, -3.79, P < 0.00001; 1 month, -3.63, P < 0.00001; 3 months, -3.02, P = 0.01; 6 months, -3.48, P = 0.01) and numerical rating scale (NRS) (SMD: 1 month, -2.83, P < 0.00001; 3 months, -3.51, P < 0.00001; 6 months, -4.00, P < 0.00001), and improved functional outcomes, as assessed by physical function (PF) (SMD: 3 months, 0.63, P = 0.006; 6 months, 0.47, P = 0.002) and the Oswestry Disability Index (ODI) (SMD: 1 month, -2.18, P = 0.002; 3 months, -2.73, P = 0.008; 6 months, -2.50, P = 0.0002), in patients with DLBP. Comparative analysis revealed both that shorter-duration interventions (equivalent temperatures) resulted in superior VAS, NRS, ODI, and Roland-Morris Disability Questionnaire (RMDQ) scores; and that lower-temperature protocols (equivalent durations) resulted in greater improvements in PF, body pain (BP), and ODI scores. Notably, medium-temperature/short-duration protocols outperformed low-temperature/short-duration regimens in terms of ODI score reduction, as shown by Delta Standardized Mean Difference (ΔSMD) (ΔSMD = 4.53, P > 0.05). However, these symptoms were relieved within a short period of time. No severe adverse events were reported in any of the studies.

CONCLUSION

1. RFA is safe and effective for the treatment of DLBP. 2. A radiofrequency protocol of 55 °C for 4 min may represent a potential optimal parameter combination.