title: A comprehensive review of pulsed radiofrequency in the treatment of pain associated with different spinal conditions.
abstract: OBJECTIVE
  The objective of this review was to evaluate the efficacy of pulsed radiofrequency (PRF) treatment of pain associated with different spinal conditions. The mechanisms of action and biological effects are shortly discussed to provide the scientific basis for this radiofrequency modality.
  
  
  METHODS
  We systematically searched for clinical studies on spinal clinical conditions using PRF. We searched the MEDLINE (PubMed) database. We classified the information in one table focusing on randomized controlled trials (RCTs) and other types of studies. Date of last electronic search was October 2016.
  
  
  RESULTS
  We found four RCTs that evaluated the efficacy of PRF on cervical radicular pain and five observational studies. Two trials and three observational studies were conducted in patients with facet pain. For disc-related pathology, we found one RCT with PRF applied intradiscally and three RCTs for dorsal root ganglia PRF modulation lumbosacral radicular pain. For sacroiliac joint pain, spondylolisthesis, malignancies and other minor spinal pathology, limited studies were conducted.
  
  
  CONCLUSIONS
  From the available evidence, the use of PRF to the dorsal root ganglion in cervical radicular pain is compelling. With regard to its lumbosacral counterpart, the use of PRF cannot be similarly advocated in view of the absence of standardization of PRF parameters, enrolment criteria and different methods in reporting results; but, the evidence is interesting. The use of PRF in lumbar facet pain was found to be less effective than conventional RF techniques. For the other different spinal conditions, we need further studies to assess the effectiveness of PRF. Advances in knowledge: The use of PRF in lumbar facet pain was found to be less effective than conventional RF techniques. For the other different spinal conditions, we need further studies to assess the effectiveness of PRF.
authors.affiliation: 1 Department of Radiology, Scientific Institute Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Facchini
authors.affiliation: 1 Department of Radiology, Scientific Institute Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Spinnato
authors.affiliation: 2 Department of Radiology, Scientific Institute Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Guglielmi
authors.affiliation: 1 Department of Radiology, Scientific Institute Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Albisinni
authors.affiliation: 1 Department of Radiology, Scientific Institute Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bazzocchi
mesh_terms: D001416:Back Pain / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008161:Lumbosacral Region / Q000503:physiopathology; D061208:Pulsed Radiofrequency Treatment / Q000379:methods*; D013122:Spinal Diseases / Q000150:complications* / Q000503:physiopathology; D016896:Treatment Outcome