Authors' objectives:

This health technology assessment report critically examines the efficacy, effectiveness, and safety of percutaneous radio-frequency neurotomy (PRFN) treatment of chronic neck-pain following whiplash injury of the neck. The secondary purpose of this health technology assessment is to estimate the provincial population health impact of PRFN.

Authors' recommendations: 1. Percutaneous radio-frequency neurotomy (PRFN) treatment of chronic pain proven to arise in the zygapophysial joint following whiplash injury has become a new, albeit uncommon, therapeutic option in British Columbia. 2. PRFN treatment has been shown effective versus placebo at relieving chronic pain proven to arise in the zygapophysial joint following whiplash injury, in one double-blind, randomized controlled trial of 24 carefully-selected patients. PRFN provides relief of pain for short to moderately long periods. 3. There is no efficacy or effectiveness evidence from controlled trials comparing PRFN to any alternative therapy to treat chronic neck pain following whiplash injury. 4. The efficacy of PRFN in one highly-specialized setting is promising, but there is an overall lack of evidence of effectiveness. While treatment benefits have been demonstrated in a clinical setting of excellence, realistic concerns must be raised about replicability outside this setting. 5. There are no studies of sufficient sample size to evaluate properly the potential acute complications or potential long-term harm that could result from widespread adoption of PRFN for chronic zygapophysial joint pain. 6. Public policy seeking to balance patient demand against concern about the lack of effectiveness evidence may consider resource allocation for training, accreditation, and limited dissemination, conditional on outcome research.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.chspr.ubc.ca/bcohta/

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: British Columbia Office of Health Technology Assessment

Contact Address: B. C. Office of Health Technology Assessment, Centre for Health Services and Policy Research, S-184 Koerner Pavilion, 2211 Wesbrook Mall, The University of British Columbia, Vancouver, B. C., V6T 1Z3, Canada.

Copyright: BCOHTA