The Effect and Role of Steroids in Facet Joint Radiofrequency Denervation: a Narrative Review

Purpose of Review There is ongoing controversy regarding the role of steroids in facet joint radiofrequency denervation and its associated side effects. We reviewed the available evidence to ascertain whether steroids confer any therapeutic value, affect lesion size, or prevent neuritis among other considerations. Recent Findings A review of the current body of literature identified a limited number of qualified studies and there is no general consensus regarding evidence-based justifications for steroids in facet joint radiofrequency denervation. Summary Based on the current available evidence regarding the potential utility of steroids in facet joint radiofrequency denervation, we conclude that steroids may (1) play a role in preventing neuritis, (2) have a potentially negative impact on lesion size when given before denervation, and (3) theoretically provide long-term therapeutic pain relief in a small subset of patients. Further studies including multi-institutional randomized placebo-controlled studies are greatly needed to clinically guide the use of steroids in facet joint radiofrequency denervation.