Original Title: Efectividad y seguridad de la nucleolisis por radiofrecuencia en el tratamiento del dolor lumbar crónico o agudo

Authors' objectives: To evaluate the effectiveness, safety and efficiency of radiofrequency nucleolysis (NL-RF) in the treatment of chronic or acute low back pain, together with the ethical, legal, organisational, social and environmental aspects of this health technology.

Authors' results and conclusions: CONCLUSIONS: The studies included in this review were highly heterogeneous in terms of both design and study samples. In addition, some presented a high risk of bias at different levels. With this in mind, the following conclusions can be drawn: • RF-assisted NL has not been shown to be inferior to NL performed using other techniques (thermal, laser, ozone, mechanical or PRP). NLRF could be comparable in effectiveness to other techniques (certainty of evidence: low or very low). In terms of safety, NL-RF is likely to have a similar profile to the techniques compared (moderate certainty of evidence). • NL-RFNP could be worse than its comparators in improving pain as measured by VAS (certainty of evidence: low). • The safety profile of NL-RF is likely to be similar to that of its comparators (moderate certainty of evidence). • No evidence has been found on the efficiency or cost-effectiveness of NL-RF compared to other therapeutic alternatives.

Authors' methods: A systematic review (SR) of the available scientific literature on the effectiveness, safety and efficiency of NL-RF in patients with chronic or acute discogenic LBP was conducted. The PICO criteria were used to select the studies for inclusion: • Population: People with low back pain • Intervention: Radiofrequency nucleolysis • Comparator: Nucleolysis by other techniques, spinal neuromodulation, ablation, denervation, neurotomy or rhizolysis, transcutaneous electrical nerve stimulation (TENS), interferential electrical currents (IFC), ultrasound, epidural corticosteroids, etc. • Outcomes: pain, functional capacity/disability, clinical improvement, quality of life, reduction in medication, time to surgery, adverse events, complications, iatrogenesis and morbidity associated with the intervention, cost-effectiveness or cost-utility ratio, results on ethical, legal, organisational, social and environmental aspects. Where possible, meta-analyses were performed using the Revman 5.4 tool.

Project Status: Completed

Year Published: 2025

URL for published report: https://hdl.handle.net/20.500.12105/26936

URL for additional information: https://redets.sanidad.gob.es/productos/buscarProductos.do?metodo=detalle&id=1337

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Agencia de Evaluacion de Tecnologias Sanitarias

Contact Address: Instituto de Salud "Carlos III", Calle Sinesio Delgado 6, Pabellon 4, 28029 Madrid, Spain. Tel: +34 9 1 822 2005; Fax: +34 9 1 387 7841;

Contact Name: Esther E. García Carpintero

Contact Email: eegarcia@isciii.es

Copyright: Agencia de Evaluacion de Tecnologias Sanitarias