Radiofrequency Denervation on Lumbar Facet Joint Pain in the Elderly: A Randomized Controlled Prospective Trial.
Bibliographic record
Abstract
BACKGROUND: Lumbar facet joint (LFJ) pain is the most common cause of low back pain in the elderly. Denervation of the medial branch of the spinal dorsal ramus can theoretically achieve long-term pain relief. Yet there is little evidence of high-level prospective randomized controlled research. OBJECTIVES: To observe the effect of radiofrequency (RF) denervation of the medial branch of the spinal dorsal ramus on LFJ pain in the elderly. STUDY DESIGN: A prospective randomized controlled study. SETTING: The study was performed in the National Pain Management and Research Center of China-Japan Friendship Hospital. METHODS: A total of 270 patients over 60 years old with LFJ pain were randomly divided into an RF group (n = 135) and a control group (n = 135). They received radiofrequency denervation intervention and a conventional conservative approach, respectively. The follow-up was 6 months. The main outcome was the NRS pain score (0-10 points) and the proportion of patients with a pain reduction of more than 2 points (minimum difference of clinically significant difference). The secondary outcome was the Oswestry Disability Index (ODI), the proportion of patients whose ODI decreased by more than 15 points, and the Macnab standard efficacy evaluation. The factors that influenced the excellent and good Macnab rates were analyzed by univariate and multivariable regression analysis. RESULTS: There were more women than men who suffered from LFJ (171/99) pain based in these 270 patients. The numeric rating scale (NRS) pain score changes in the RF group were significantly different from those in the control group at the 1st, 3rd, and 6th months (-2.3 vs -1.2, -2.0 vs -1.2, -2.0 vs -1.1, P < 0.001), and the proportion of patients whose NRS decreased by ? 2 was higher than that in the control group at the 3rd and 6th months (61.1% vs 26.0%, 52.9% vs 22.5%, P < 0.001). The ODI score changes in the RF group were significantly different from that in the control group at the 1st, 3rd, and 6th months (-15.2 vs -10.1, -14.6 vs -8.6, -13.6 vs -7.7, P < 0.001), and the proportion of ODI reduction ? 15 was also higher than that in the control group at the 3rd and 6th months (45.8% vs 34.1%, 36.4% vs 27.0%, P < 0.05). The excellent rate and efficiency of the Macnab evaluation in the RF group at the 6th month was significantly higher compared to the control group (60.3% vs 36.0%, 81.0% vs 54.1%, P < 0.001). The independent factor affecting the excellent and good rate is failed back surgery syndrome. LIMITATION: The limitation of this study is that it was only performed in one unit of the National Pain Management and Research Center. It needs to be further carried on in multiple centers in the future. CONCLUSIONS: Radiofrequency denervation can effectively reduce LFJ pain and improve movement disorder. The effect is good until 6 months later.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".