Low back pain is the #1 contributor to years lived with disability and health care costs in the United States (US), driven mainly by chronic low back pain.
Lumbar radiofrequency ablation (LRFA) is a minimally invasive procedure for chronic low back pain that is commonly used in the United States, covered by Medicare and commercial insurers. Some randomized trials have shown that LRFA can result in meaningful improvements in pain and physical function when compared to a control procedure. However, definitive evidence of the effectiveness of LRFA compared to a control procedure has not yet been demonstrated in a large-scale multicenter randomized trial.
The goal of the ASTRAL (A Superiority Trial of Radiofrequency Ablation for Low Back Pain) study is to compare the effectiveness of different techniques for lumbar radiofrequency ablation of the medial branch nerves for improving back-related functional limitations for patients with chronic low back pain
The technical methods being compared include lumbar radiofrequency ablation using a conventional electrode (LRFA-C), lumbar radiofrequency ablation using a multi-tined electrode (LRFA-M), and a simulated lumbar radiofrequency ablation control procedure in which no thermal ablation occurs (simulated LRFA).