Authors: Park H et al.
BMJ Journals Regional Anesthesia & Pain Medicine, 2025. | DOI: Not provided
This network meta-analysis evaluated the comparative effectiveness of pulsed radiofrequency (PRF) and epidural neuroplasty for managing lumbar radicular pain (LRP) in patients refractory to conservative treatments, such as epidural steroid injections (ESI). The analysis included 14 randomized controlled trials (RCTs) with a total of 1,229 patients suffering from LRP due to disc herniation, spinal stenosis, or failed back surgery syndrome.
Pain reduction was assessed at 1, 3, 6, and 12 months post-treatment. At 1 month, there was no significant difference between PRF and epidural neuroplasty. By 3 months, epidural neuroplasty demonstrated a significant advantage over PRF (mean difference: −1.47; 95% CI −2.73 to −0.46), though the certainty of evidence was low. Similar trends persisted at 6 and 12 months, but the confidence in these findings remained low to very low. Regarding functional disability (measured by the Oswestry Disability Index), no significant differences were observed between interventions at any time point, with evidence certainty ranging from moderate to very low.
The study concludes that PRF and epidural neuroplasty may offer comparable long-term outcomes in pain and disability for LRP patients. However, the overall low certainty of evidence prevents definitive clinical recommendations, underscoring the need for high-quality, direct comparison trials to guide optimal treatment selection.
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Authors: Park H et al. 2025.
BMJ Journals Regional Anesthesia & Pain Medicine. DOI: Not provided
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