Radiofrequency Ablation of Basivertebral and Sinuvertebral Nerves for Chronic Discogenic Low Back Pain: A Systematic Review and Meta-analysis

Introduction: Radiofrequency ablation (RFA) of the basivertebral and sinuvertebral nerve is a relatively new intervention for patients with chronic discogenic low back pain. It aims to ablate the irritated nerve endings to improve pain control and disability and avoid the need for a major surgical procedure for decompression in these patients. This meta-analysis includes prospective single and double-arm studies that determine if RFA effectively improves chronic low back pain and disability for patients with degenerative spinal discs.

Methods: The outcomes of interest were comprised of commonly used patient-reported outcomes, which included the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores. Forest plots were generated to report associations, and funnel plots to report the risk of publication bias.

Results: The meta-analysis included 429 patients from five eligible studies, comprising of two randomized controlled trials and three prospective single-arm trials. A total of 280 patients underwent RFA, whereas 149 served as controls. The baseline scores in the single-arm trials served as the outcomes of their control group. The RFA group (n=280) had significantly lower ODI scores (mean difference = -28.08; 95% CI: [-43.53, -12.63]) than the control group (n=240). Similarly, the RFA group (n=279) had significantly lower VAS scores (mean difference = -3.16; 95% CI: [-5.02, -1.31]) than the control group (n=238).

Conclusion : In patients with chronic discogenic low back pain, RFA of basivertebral and sinuvertebral nerves is superior to conservative therapy for improvement in pain control and disability. It can offer better functional status and quality of life in these patients without the need for major decompressive surgery.