Point of View

摘要

In an outcome study, Dreyfuss et al demonstrated how good the outcomes could be from lumbar medial branch neurotomy. Yet that study was variously chastised: for having no controls; for being highly selective in its recruitment criteria; for enrolling only a tiny proportion of potential patients; and, therefore, for being too small a study. Subsequently, systematic reviews demanded randomized controlled trials of lumbar medial branch neurotomy, but none of the controlled trials that followed used correct surgical technique for this procedure; and none selected patients on the basis of controlled diagnostic blocks