To the Editor The study by Dr Juch and colleagues1 investigated the effect of radiofrequency denervation plus an exercise program compared with the exercise program alone for patients with chronic low back pain. We note several flaws in the design of the study.
First, the methods the authors used to diagnose facet pain, a single positive diagnostic facet medial branch block prior to radiofrequency denervation, were not rigorous. The false-positive rate of this method can be as high as 45%,2 which could explain the increased number of treatment failures in the intervention group.
Rimmalapudi V, Buchalter J, Calodney A. Radiofrequency Denervation for Chronic Low Back Pain. JAMA. 2017;318(22):2255–2256. doi:10.1001/jama.2017.16378
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