Dorsal root ganglion pulsed radiofrequency treatment for chronic cervical radicular pain: a retrospective review of outcomes in fifty-nine cases

O'Gara, Aine; Leahy, Aine; McCrory, Connail; Das, Basabjit

doi:10.1007/s11845-019-02087-4

Cited by 9 publications

(5 citation statements)

References 24 publications

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“…In our study, 15 patients in group I (75%),14 patients in group II (70%) and 10 patients in group III (50%) who were taking medications prior to all procedures reduced or discontinued their use. Those results are comparable to the results reported by O'Gara et al, 14 who postulated that 69% of patients who had PRF at the cervical DRG decreased or discontinued pain medications.…”

Section: Discussionsupporting

confidence: 90%

“…The results of our study as regards PRF are similar to previous studies as most of them showed clinically significant reduction in pain of 60% to 70% of patients. [12][13][14] The one-year follow-up period in study provides confidence that the symptom reduction associated with both active treatments is not short term. In with our study, one previous prospective study conducted by Choi et al 15 showed that 66.7% of patients who were subjected to PRF had clinically significant pain reduction after 1 year follow up period.…”

Section: Discussionmentioning

confidence: 94%

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Percutaneous Pulsed Radiofrequency versus Combined Intradiscal Oxygen-Ozone Therapy with Percutaneous Radiofrequency for Management of Discogenic Cervical Radiculopathy

Daghedy,

Rabie,

Elwany

et al. 2023

Pan Arab Journal of Neurosurgery

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BACKGROUND: Cervical radiculopathy can lead to severe disability. Non-invasive treatment can be the primary option in many circumstances. Minimally invasive therapies were developed to provide good clinical results while also being a low-cost technique that is well tolerated. These methods have gained popularity in recent years as it avoids severe soft-tissue injury, extensive hospitalization, and a lengthy recovery period. Radiofrequency (RF) is classified into continuous radiofrequency, which uses thermocoagulation, and pulsed radiofrequency (PRF), which uses an electromagnetic field. OBJECTIVE:The aim of this study was to compare between PRF at the cervical root combined with intradiscal ozone injection and PRF alone for treatment of patients with discogenic cervical radiculopathy. PATIENTS AND METHODS:The present study was carried out at Neurosurgery department, Alexandria University on 60 patients with cervical radiculopathy in a randomized controlled clinical trial. Patients were randomly allocated by a computer based program into three groups (20 patients each). In group I patients had PRF combined with intradiscal oxygen-ozone, in group II patients had PRF alone, and in group III, the control group, patients received only diagnostic blocks. RESULTS:Our study showed that PRF combined with intradiscal ozone and pulsed RF alone had good clinical outcome when comparing it to control group in terms of reduction of pain, need of medications, neck disability index and need for surgery. There was significant shrinkage of herniated disc fragment in magnetic resonance imaging (MRI) done 3 months after intervention in 5 patients in Group I. CONCLUSION:Combining pulsed RF with intradiscal ozone provides good clinical and radiological outcome in patients with cervical disc herniation and can be tried before open discectomy for patients with cervical disc herniation.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 94%

Percutaneous Pulsed Radiofrequency versus Combined Intradiscal Oxygen-Ozone Therapy with Percutaneous Radiofrequency for Management of Discogenic Cervical Radiculopathy

Daghedy,

Rabie,

Elwany

et al. 2023

Pan Arab Journal of Neurosurgery

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“…In patients treated by lidocaine intravenous infusion combined with pulsed radiofrequency ( T 5 ), among the serum inflammatory index manifestations, inflammatory factors such as sedimentation, calcitonin, CRP, CGRP, and IL-6 decreased with remission, and to a more significant extent than in group A( Table 5 and Figure 6 ). Consistent with the literature, early pain control during the treatment of subacute herpes zoster improved the level of serum inflammation in patients [ 33 ]. When comparing patients' opioid pain medication ( Table 4 and Figure 5 ) consumption at the same time point as the serum inflammatory index, morphine extended-release tablet consumption was significantly lower in group B than in group Ke et al [ 34 ] confirmed that pulsed radiofrequency treatment significantly reduced pain medication use by evaluating pulsed radiofrequency with the evaluation of pain medication use.…”

Section: Discussionsupporting

confidence: 85%

Clinical Efficacy of Pulsed Radiofrequency Combined with Intravenous Lidocaine Infusion in the Treatment of Subacute Herpes Zoster Neuralgia

Zhang¹,

2022

Pain Research and Management

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Objective. Under the guidance of a digital subtraction angiography (DSA) machine, via fluoroscopic imaging techniques, patients diagnosed with herpes zoster neuralgia at the subacute stage, where self-reported pain lasts between 30 and 90 days, were treated with nerve pulsed radiofrequency surgery combined with intravenous lidocaine infusion or saline infusion as control. This study explores the clinical efficacy, safety, and clinical value of the combined treatment compared with nerve pulsed radiofrequency surgery alone. Methods. In this study, 72 patients diagnosed with herpes zoster neuralgia at the subacute stage were randomly divided into two groups with matched gender, age, and clinical symptoms. Both groups received pulsed radiofrequency surgery for the affected nerve segments under DSA fluoroscopy. Five days after the operation, 0.9% saline was administered daily for five consecutive days (50 ml per day, intravenous infusion) to group A (n = 36), and lidocaine was administered daily for five consecutive days (3 mg per kg per day, intravenous infusion) to group B (n = 36). Patients with poor pain control during the treatment were given 10 mg morphine tablets for pain relief to reach visual analog scale (VAS) ≤4 points. Data of the following categories were collected: VAS score, self-rating anxiety scale (SAS) score, depression self-rating scale (SDS) score, Pittsburgh sleep quality score (PSQI), 45 body area rating scale score, skin temperature measurement using infrared thermography, analgesic drug use before and after treatment at six different time points: before surgery (T0), one day after surgery (T1), three days after surgery (T2), five days after surgery (T3), one month after surgery (T4), and two months after surgery (T5). Blood was collected from all patients in the morning before surgery and right after the last intravenous infusion of lidocaine at T3. Serum inflammatory indexes including white blood cell count, lymphocyte count, neutrophils count, erythrocyte sedimentation rate count, C-reactive protein (CRP) level, calcitonin gene-related peptide (CGRP) level, and interleukin-6(IL-6) level were determined. Lastly, the incidence of complications and adverse reactions throughout the study was recorded. Results. In total, 64 out of 72 patients completed the whole study. Two patients met the exclusion criteria in group A, one patient refused to participate, and one was lost to follow-up. Two patients met the exclusion criteria in group B, and two were lost to follow-up. Three patients in group B experienced vomiting during lidocaine treatment. The adverse symptom was relieved after symptomatic treatment. No patients in the two groups had severe complications such as hematoma at the puncture site, pneumothorax, and nerve injury. Compared with before treatment, the mean of VAS score, SAS score, SDS score, PSQI score, and skin temperature of both groups at each time point after interventional surgery were all significantly reduced. Furthermore, at each time point after surgery, the above indicators of group B patients were significantly lower than those of group A patients. After treatment, the consumption of analgesics in both groups was significantly lower than before treatment. Compared with group A, the consumption of analgesics was also significantly lower in group B. In addition, serum inflammatory indexes at the T3 time point of the two groups of patients were lower than T0. Among them, the erythrocyte sedimentation rate, CRP level, CGRP level, and interleukin-6 level of group B were significantly lower than those of group A. The incidence of postherpetic neuralgia (PHN) in group B patients (6.25%) was also lower than that in group A patients (25%). Conclusion. DSA-guided nerve pulse radiofrequency surgery combined with intravenous lidocaine infusion can effectively relieve pain in patients diagnosed with herpes zoster nerves at the subacute stage, reduce the number of analgesic drugs used in patients, reduce postherpetic neuralgia incidence rate, and improve sleep and quality of life.

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“…Many RCT studies, as displayed by Farì et al [17] in their meta-analysis, demonstrated that both pulsed or continuous or water-cooled RF (WCRF), could represent a promising therapy for treating chronic musculoskeletal pain, especially when other approaches are ineffective or not practicable. Their group also showed that continuous RF combined with therapeutic exercise in rehabilitating severe hip osteoarthritis is an attractive option for significant pain relief as it allows patients to carry out kinesitherapy more easily [18].…”

Section: Discussionmentioning

confidence: 99%

Is Electrocatheter-Mediated High-Voltage Pulsed Radiofrequency of the Dorsal Root Ganglion an Effective Adjuvant to Epidural Adhesiolysis in the Treatment of Chronic Lumbosacral Radicular Pain? A Retrospective Analysis

Grua¹,

Sindaco²,

Zanella³

et al. 2023

OBM Neurobiol

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This study aims to determine if high-voltage PRF could effectively adjunct epidural adhesiolysis (EA) in treating patients with chronic lumbosacral radiating pain (LSRP) and neuropathic characteristics. A total of 409 patients suffering from a single leg-radiating pain lasting for > six months and unresponsive to previous treatments were divided into three different groups: Group 1 consisted of 227 patients suffering from LSRP in lumbar stenosis, 84 treated with EA alone and 143 with PRF-EA; group 2 consisted of 99 patients suffering from LSRP in FBSS (Failed Back Surgery Syndrome), 24 treated with EA alone and 75 with PRF-EA; group 3 consisted of 83 patients suffering for LSRP in discal herniation, 20 treated with EA and 63 with PRF-EA. NRS evaluated the outcome at rest and in movement, SF-12 Physical and Mental Health Summary Scales, and present pain intensity scale (PPI), before the treatment and at the 1-month follow-up for all the patients included in the study. Descriptive statistics (mean ± SD) were reported for NRSrest, NRSmov, PPI, PCS, and MCS scores. A dependent sample T-test was used to compare pre and post-treatment outcome measures (NRS, PPI, PCS, MCS), in patients treated for discal herniation, FBSS and stenosis, respectively. A potential difference in outcome between the different procedures performed in the three groups (EA + PRF versus EA alone) was analyzed by applying an independent two-tailed t-test. P value less than 0.05 represented a significant difference. A significant reduction of radiating pain was observed at one-month follow-up in NRSrest and NRSmov, PPI scores, for all the three groups of patients, independently of the treatment adopted (p < 0.001). PCS12 and MCS12 significantly increased for all three groups of patients at 1-month follow-up (p < 0.001). No significant differences in outcome were detected for both procedures (EA vs. PRF-EA) in all three groups (p > 0.05). PRF and PRF-EA effectively reduce neuropathic pain intensity and improve the quality of life in patients who suffer from lumbosacral radiating pain in the context of lumbar stenosis, FBSS, or discal herniation. Adding pulsed radiofrequency (PRF) to epidural adhesiolysis alone does not improve the outcome.

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Dorsal root ganglion pulsed radiofrequency treatment for chronic cervical radicular pain: a retrospective review of outcomes in fifty-nine cases

Cited by 9 publications

References 24 publications

Percutaneous Pulsed Radiofrequency versus Combined Intradiscal Oxygen-Ozone Therapy with Percutaneous Radiofrequency for Management of Discogenic Cervical Radiculopathy

Percutaneous Pulsed Radiofrequency versus Combined Intradiscal Oxygen-Ozone Therapy with Percutaneous Radiofrequency for Management of Discogenic Cervical Radiculopathy

Clinical Efficacy of Pulsed Radiofrequency Combined with Intravenous Lidocaine Infusion in the Treatment of Subacute Herpes Zoster Neuralgia

Is Electrocatheter-Mediated High-Voltage Pulsed Radiofrequency of the Dorsal Root Ganglion an Effective Adjuvant to Epidural Adhesiolysis in the Treatment of Chronic Lumbosacral Radicular Pain? A Retrospective Analysis

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