Contreras Lopez William Omar, Navarro Paula Alejandra, Vargas Marcos David, Alape Eduardo, Camacho Lopez Paul Anthony
Centro Internacional de Investigación NEMOD, Bucaramanga, Colombia; Division de Neurocirugía Funcional, Departamento de Neurocirugía, Clínica FOSCAL, Bucaramanga, Colombia; Universidad Autónoma de Bucaramanga, UNAB, Bucaramanga, Colombia; Centro Colombiano y Fundación de Epilepsia y Enfermedades Neurológicas: FIRE, Cartagena, Colombia.
Centro Internacional de Investigación NEMOD, Bucaramanga, Colombia; Division de Neurocirugía Funcional, Departamento de Neurocirugía, Clínica FOSCAL, Bucaramanga, Colombia; Universidad Autónoma de Bucaramanga, UNAB, Bucaramanga, Colombia.
World Neurosurg. 2019 Feb;122:390-396. doi: 10.1016/j.wneu.2018.10.191. Epub 2018 Nov 4.
To compare pulsed radiofrequency (PRF) treatment with continuous radiofrequency (CRF) to improve pain, functionality, and safety profile in patients with facet joint chronic low back pain.
A systematic, critical review of recent literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Cochrane, Clinical Trials, and LILACS databases were searched. Medical Subject Heading terms were "low back pain," "zygapophyseal joint," and "pulsed radiofrequency treatment." Original research articles in peer-reviewed journals were included in the review. The articles were thoroughly examined and compared on the basis of study design and outcomes. Only studies that met the eligibility criteria were included.
Three randomized clinical trials comprising 103 patients (39 in PRF group, 44 in CRF group, and 20 in control group) were included in the final analysis. Two trials compared PRF with CRF, and 1 trial compared 3 groups: PRF, CRF, and control with intervention as conventional treatment. The studies reported greater pain control and better functionality with CRF compared with PRF. PRF showed a decrease in visual analog scale and Oswestry Disability Index in 2 studies, and 1 study reported increased pain and disability after the intervention. No side effects were reported.
PRF treatment is less effective than CRF regarding pain control and return of functionality in patients with facet joint chronic low back pain. We recommend CRF with a large safety profile after conventional treatment.
比较脉冲射频（PRF）治疗与连续射频（CRF）治疗对小关节慢性下腰痛患者疼痛、功能及安全性的影响。
按照系统评价和Meta分析的首选报告项目指南，对近期文献进行系统的批判性综述。检索了PubMed、Embase、Cochrane、临床试验和LILACS数据库。医学主题词为“下腰痛”“关节突关节”和“脉冲射频治疗”。综述纳入同行评审期刊上的原始研究文章。根据研究设计和结果对文章进行全面审查和比较。仅纳入符合纳入标准的研究。
最终分析纳入了3项随机临床试验，共103例患者（PRF组39例，CRF组44例，对照组20例）。2项试验比较了PRF与CRF，1项试验比较了3组：PRF、CRF和采用传统治疗作为干预措施的对照组。研究报告称，与PRF相比，CRF在疼痛控制和功能改善方面效果更佳。2项研究显示PRF组视觉模拟评分和Oswestry功能障碍指数有所下降，1项研究报告干预后疼痛和功能障碍增加。未报告有副作用。
在小关节慢性下腰痛患者的疼痛控制和功能恢复方面，PRF治疗的效果不如CRF。我们建议在传统治疗后采用安全性良好的CRF治疗。
