Percutaneous Radiofrequency Spinal Rhizotomy

Pagura, Jorge Roberto

doi:10.1159/000101253

Cited by 14 publications

(15 citation statements)

References 4 publications

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“…32 However, despite its widespread use and well-documented efficacy, this treatment did not seem to be ideal for treating lumbar radicular pain because neurodestructive methods are, in principle, considered inappropriate for the treatment of neuropathic pain (for example, because of denervation dysesthesia and other adverse neurologic effects). 9,35,42,43 In 1998, Sluijter et al 36 introduced an isothermal radiofrequency treatment-PRF-for the relief of chronic pain.…”

mentioning

confidence: 99%

Changes in pain behavior and glial activation in the spinal dorsal horn after pulsed radiofrequency current administration to the dorsal root ganglion in a rat model of lumbar disc herniation

Cho

Kim

et al. 2013

SPI

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Object Herniated discs can induce sciatica by mechanical compression and/or chemical irritation caused by proinflammatory cytokines. Using immunohistochemistry methods in the dorsal horn of a rat model of lumbar disc herniation, the authors investigated the effects of pulsed radiofrequency (PRF) current administration to the dorsal root ganglion (DRG) on pain-related behavior and activation of microglia, astrocytes, and mitogen-activated protein kinase. Methods A total of 33 Sprague-Dawley rats were randomly assigned to either a sham-operated group (n = 10) or a nucleus pulposus (NP)–exposed group (n = 23). Rats in the NP-exposed group were further subdivided into NP exposed with sham stimulation (NP+sham stimulation, n = 10), NP exposed with PRF (NP+PRF, n = 10), or euthanasia 10 days after NP exposure (n = 3). The DRGs in the NP+PRF rats were exposed to PRF waves (2 Hz) for 120 seconds at 45 V on postoperative Day 10. Rats were tested for mechanical allodynia 10 days after surgery and at 8 hours, 1 day, 3 days, 10 days, 20 days, and 40 days after PRF administration. Immunohistochemical staining of astrocytes (glial fibrillary acidic protein), microglia (OX-42), and phosphorylated extracellular signal–regulated kinases (pERKs) in the spinal dorsal horn was performed at 41 days after PRF administration. Results Starting at 8 hours after PRF administration, mechanical withdrawal thresholds dramatically increased; this response persisted for 40 days (p < 0.05). After PRF administration, immunohistochemical expressions of OX-42 and pERK in the spinal dorsal horn were quantitatively reduced (p < 0.05). Conclusions Pulsed radiofrequency administration to the DRG reduced mechanical allodynia and downregulated microglia activity and pERK expression in the spinal dorsal horn of a rat model of lumbar disc herniation.

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confidence: 99%

Changes in pain behavior and glial activation in the spinal dorsal horn after pulsed radiofrequency current administration to the dorsal root ganglion in a rat model of lumbar disc herniation

Cho

Kim

et al. 2013

SPI

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“…132 Although surgical rhizotomy initially led to impressive short-term pain relief in patients with various pain syndromes, 133 in the long term a dramatic loss of efficacy occurred, accompanied by severe adverse effects if substantial denervation had been carried out. 132 Although surgical rhizotomy initially led to impressive short-term pain relief in patients with various pain syndromes, 133 in the long term a dramatic loss of efficacy occurred, accompanied by severe adverse effects if substantial denervation had been carried out.…”

Section: Lumbar Radicular Painmentioning

confidence: 99%

“…In patients with radiating lower limb pain, one prospective 137 and several retrospective studies 10,132,[138][139][140] reported beneficial effects of lumbosacral RF-DRG in 32% to 76% of cases. In a previous retrospective study, 279 patients underwent RF-DRG because of chronic spinal pain radiating to the leg, and an initial success rate of approximately 60% was reported.…”

Section: Evidence For Radiofrequency Treatment Of the Dorsal Root Ganmentioning

confidence: 99%

Radiofrequency Treatment

Eerd¹,

Kleef²,

Zundert³

2014

Practical Management of Pain

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“…In the 1980s, percutaneous RF treatment was introduced 10. RF treatments are divided into continuous radiofrequency (CRF) stimulation and pulsed radiofrequency (PRF) stimulation using an electromagnetic field.…”

Section: Introductionmentioning

confidence: 99%

Effect of Intradiscal Monopolar Pulsed Radiofrequency on Chronic Discogenic Back Pain Diagnosed by Pressure-Controlled Provocative Discography: A One Year Prospective Study

et al. 2012

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ObjectiveTo investigate the efficacy and safety of percutaneous intradiscal monopolar pulsed radiofrequency (PRF) in patients with chronic disabling discogenic back pain.MethodTwenty-six subjects (7 males; mean age 43.2 years) with chronic back pain refractory to active rehabilitative management were recruited. All subjects underwent MRI for evaluation of Modic changes, and monopolar PRF (20 min at 60 V) at the center of target lumbar intervertebral disc confirmed by pressure-controlled provocative discography. Clinical outcomes were measured by the visual analogue scale (VAS), Oswestry disability index (ODI), and sitting tolerance time (ST) for 12 months after treatment. Successful clinical outcome was described as a minimum of 2 point reduction in VAS compared with the baseline at each follow-up period.ResultsThe mean VAS for low back pain reduced significantly from 6.4±1.1 at pre-treatment to 4.4±1.9 at 12 months (p<0.05). The mean ODI score was 47.3±15.4 points at pre-treatment and 36.7±19.5 at 12 months (p<0.001). The ST was 27.8±20.4 minutes at pre-treatment and 71.5±42.2 at 12 months (p<0.001). However, successful clinical outcome was achieved at 58%, 50%, and 42%, measured at 3, 6, and 12 months post-treatment. There were no significant relationship between the clinical outcome and Modic changes; no adverse events were recorded.ConclusionThe results demonstrated that the application of intradiscal monopolar PRF might be relatively effective but limited; successful intervention for chronic refractory discogenic back pain is needed. To achieve the optimal outcome through intradiscal PRF, we suggested further studies about stimulation duration, mode, and intensity of PRF.

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Percutaneous Radiofrequency Spinal Rhizotomy

Cited by 14 publications

References 4 publications

Changes in pain behavior and glial activation in the spinal dorsal horn after pulsed radiofrequency current administration to the dorsal root ganglion in a rat model of lumbar disc herniation

Changes in pain behavior and glial activation in the spinal dorsal horn after pulsed radiofrequency current administration to the dorsal root ganglion in a rat model of lumbar disc herniation

Radiofrequency Treatment

Effect of Intradiscal Monopolar Pulsed Radiofrequency on Chronic Discogenic Back Pain Diagnosed by Pressure-Controlled Provocative Discography: A One Year Prospective Study

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