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

Abstract

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.