Journal CME December 2024, Multifidus atrophy and/or dysfunction following lumbar radiofrequency ablation: A systematic review-PM R - 2024 - Tieppo Francio - Multifidus atrophy and or dysfunction following lumbar radiofrequency ablation A systematic

PM R - 2024 - Tieppo Francio - Multifidus atrophy and or dysfunction following lumbar radiofrequency ablation A systematic

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Pdf Summary

This systematic review assesses the potential risk of multifidus atrophy and dysfunction following lumbar radiofrequency ablation (LRFA), a procedure used for treating chronic lumbar facet joint pain. Conducted by Vinicius Tieppo Francio and colleagues, the review aimed to evaluate the quality of evidence in published studies addressing this issue. <br /><br />The review utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and vetted applicable studies for quality and any functional or structural changes in the multifidus muscle post-LRFA. Only five cohort studies were included, each recording varying degrees of changes in the multifidus muscle's structure or function, as evidenced through electromyography (EMG), magnetic resonance imaging (MRI), and ultrasound shear wave elastography (SWE).<br /><br />Findings showed that EMG-confirmed denervation and MRI indicators of atrophy or fat infiltration were reported following LRFA. Of the reviewed studies, some indicated changes consistent with multifidus muscle dysfunction or atrophy, while a few showed either no change or an apparent increase in muscle. However, the studies are marked by various limitations like small sample sizes, lack of control groups, and insufficient blinding.<br /><br />The review highlights a critical need for more high-quality, prospective studies to better understand the relationship between LRFA and multifidus muscle changes, given these limitations and the inconsistent methodologies applied across different studies. The scarcity of strong evidence results in a very low certainty regarding the association between LRFA and multifidus atrophy or dysfunction. Such studies would be essential in substantially answering this enduring clinical question, helping refine or reaffirm the technical approaches in LRFA practice. <br /><br />For anyone interested, the detailed review has been published and offers 1.0 AMA PRA Category 1 CreditTM for completion of an evaluation. It is freely accessible to AAPM&R members.

Keywords

multifidus atrophy

lumbar radiofrequency ablation

chronic lumbar facet joint pain

systematic review

Vinicius Tieppo Francio

PRISMA guidelines

electromyography

magnetic resonance imaging

ultrasound shear wave elastography

muscle dysfunction