Abstract

We commend Maas et al1 for their effort to provide a cost-effectiveness analysis (CEA) for radiofrequency denervation (RFD) used to treat various sources of chronic lumbosacral spinal pain. Notably, the analysis is based on only 2 of the total 16 centers involved in the minimal interventional treatments (MINT) trials. Regardless of whether this generalization is appropriate or not, the CEA itself is fundamentally flawed because the conclusions drawn do not reflect a CEA of appropriate or standard clinical practice. The MINT trials have been critiqued by numerous experts in the fields of spine and pain medicine and by various medical societies because of an inadequate patient selection process, critical technical flaws in the execution of the RFD procedure itself, problematic data analysis methods, and potential conflict of interest because of funding by Dutch health insurance companies.2,3,4,5,6,7