机构：[1]Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, ON, Canada[2]Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada[3]Department of Anesthesia, McMaster University, Hamilton, ON, Canada[4]Division of Rheumatology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland[5]Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA[6]Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA[7]Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA[8]The University of Sydney, Sydney Musculoskeletal Health and the Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, St Leonards, NSW 2064, Australia[9]Leuven Center for Algology and Pain Management, University Hospitals Leuven, Leuven, Belgium[10]Department of Physical Medicine and Rehabilitation, Oslo University Hospital Ullevaal, Oslo, Norway[11]Institute of Clinical Medicine, Medical Faculty, Oslo University, Oslo, Norway[12]Department of Pain Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China四川大学华西医院[13]International Trade Centre, Palais des Nations, Geneva, Switzerland[14]Chronic Pain Network, McMaster University, Hamilton, Ontario, Canada[15]The Canadian Veterans Chronic Pain Centre of Excellence, Hamilton, ON, Canada[16]Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals[17]Faculty of Medicine, University of Geneva, Switzerland[18]Division of General Internal Medicine, Department of Medicine, University Hospitals of Geneva, University of Geneva, Switzerland[19]Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland[20]Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada[21]Department of Medicine, Innlandet Hospital Trust, Gj鴙ik, Norway[22]School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China[23]The MAGIC Evidence Ecosystem Foundation, Oslo, Norway
What is the comparative effectiveness and safety of commonly used interventional procedures (such as spinal injections and ablation procedures) for chronic axial and radicular spine pain that is not associated with cancer or inflammatory arthropathy?Chronic spine pain is a common, potentially disabling complaint, for which clinicians often administer interventional procedures. However, clinical practice guidelines provide inconsistent recommendations for their use.For people living with chronic axial spine pain (≥3 months), the guideline panel issued strong recommendations against: joint radiofrequency ablation with or without joint targeted injection of local anaesthetic plus steroid; epidural injection of local anaesthetic, steroids, or their combination; joint-targeted injection of local anaesthetic, steroids, or their combination; and intramuscular injection of local anaesthetic with or without steroids. For people living with chronic radicular spine pain (≥3 months), the guideline panel issued strong recommendations against: dorsal root ganglion radiofrequency with or without epidural injection of local anaesthetic or local anaesthetic plus steroids; and epidural injection of local anaesthetic, steroids, or their combination.An international guideline development panel including four people living with chronic spine pain, 10 clinicians with experience managing chronic spine pain, and eight methodologists, produced these recommendations in adherence with standards for trustworthy guidelines using the GRADE approach. The MAGIC Evidence Ecosystem Foundation provided methodological support. The guideline panel applied an individual patient perspective when formulating recommendations.These recommendations are informed by a linked systematic review and network meta-analysis of randomised trials and a systematic review of observational studies, summarising the current body of evidence for benefits and harms of common interventional procedures for axial and radicular, chronic, non-cancer spine pain. Specifically, injection of local anaesthetic, steroids, or their combination into the cervical or lumbar facet joint or sacroiliac joint; epidural injections of local anaesthetic, steroids, or their combination; radiofrequency of dorsal root ganglion; radiofrequency denervation of cervical or lumbar facet joints or the sacroiliac joint; and paravertebral intramuscular injections of local anaesthetic, steroids, or their combination.These recommendations apply to people living with chronic spine pain (≥3 months duration) that is not associated with cancer or inflammatory arthropathy and do not apply to the management of acute spine pain. Further research is warranted and may alter recommendations in the future: in particular, whether there are differences in treatment effects based on subtypes of chronic spine pain, establishing the effectiveness of interventional procedures currently supported by low or very low certainty evidence, and effects on poorly reported patient-important outcomes (such as opioid use, return to work, and sleep quality).Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
基金：
This guideline was funded by the Chronic Pain Centre of Excellence for Canadian Veterans.
The funder had no role in the design and conduct of the study; collection, management, analysis, and
interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the
manuscript for publication. JWB is supported, in part, by a Canadian Institutes of Health Research
Canada Research Chair in the prevention and management of chronic pain.
语种：
外文
PubmedID：
第一作者：
第一作者机构：[1]Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, ON, Canada[2]Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada[3]Department of Anesthesia, McMaster University, Hamilton, ON, Canada
通讯作者：
通讯机构：[1]Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, ON, Canada[2]Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada[3]Department of Anesthesia, McMaster University, Hamilton, ON, Canada
推荐引用方式(GB/T 7714)：
Busse Jason W,Stéphane Genevay,Agarwal Arnav,et al.Commonly used interventional procedures for non-cancer chronic spine pain: a clinical practice guideline[J].BMJ (Clinical Research Ed.).2025,388:e079970.doi:10.1136/bmj-2024-079970.
APA：
Busse Jason W,Stéphane Genevay,Agarwal Arnav,Standaert Christopher J,Carneiro Kevin...&Agoritsas Thomas.(2025).Commonly used interventional procedures for non-cancer chronic spine pain: a clinical practice guideline.BMJ (Clinical Research Ed.),388,
MLA：
Busse Jason W,et al."Commonly used interventional procedures for non-cancer chronic spine pain: a clinical practice guideline".BMJ (Clinical Research Ed.) 388.(2025):e079970
