Treatment of Chronic Lumbosacral Radicular Pain Using Adjuvant Pulsed Radiofrequency: A Randomized Controlled Study

Koh, Won Uk; Choi, Seong-Soo; Karm, Myong-Hwan; Suh, Jeong Hun; Leem, Jeong Gil; Lee, Jae Do; Kim, Young Ki; Shin, Jin-Woo

doi:10.1111/pme.12624

Cited by 76 publications

(99 citation statements)

References 32 publications

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“…[7,22–28] To the best of our knowledge, 5 studies have been published on the effect of monopolar PRF on chronic lumbosacral radicular pain. [23,24,26–28] In 2008, Simopoulos et al [27] applied monopolar PRF on 37 patients with chronic lumbosacral radicular pain. Three months after the PRF to the DRG, about half of the patients reported successful pain reduction.…”

Section: Discussionmentioning

confidence: 99%

“…In 2014, Shanthanna et al [26] reported that 6 out of 16 patients with radicular pain in the leg had a good response to PRF. In 2015, Koh et al [24] reported that 31 patients who received combined PRF and TFESI showed higher treatment efficacies for at least 3 months than 31 patients who received TFESI alone in chronic radicular pain. In the same year, Van Boxem et al [28] performed PRF on the DRG of 65 patients with chronic lumbosacral radicular pain, and 50% to 60% showed a positive treatment response; its effect was sustained for at least 6 months.…”

Section: Discussionmentioning

confidence: 99%

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Comparison between bipolar pulsed radiofrequency and monopolar pulsed radiofrequency in chronic lumbosacral radicular pain

2017

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Background:Chronic lumbosacral radicular pain is a challenging medical problem with respect to therapeutic management. Many patients with lumbosacral radicular pain complain of persistent leg pain after transforaminal epidural steroid injection. Nowadays, pulsed radiofrequency (PRF) stimulation on the dorsal root ganglion (DRG) is widely used for controlling lumbosacral radicular pain.Methods:We evaluated the effect of bipolar PRF on the DRG for the management of lumbosacral radicular pain. In addition, we compared the effect of bipolar PRF to monopolar PRF. Fifty patients with chronic lumbosacral radicular pain were included in the study and randomly assigned to 1 of 2 groups, the bipolar or monopolar PRF group (n = 25 per group). Pain intensity was evaluated using a numeric rating scale (NRS) at pretreatment, and 1, 2, and 3 months after treatment.Results:When compared to the pretreatment NRS scores, patients in both groups showed a significant decrease in NRS scores at 1, 2, and 3 months after treatment. Reductions in the NRS scores over time were significantly larger in the bipolar PRF group. Three months after treatment, 19 patients (76.0%) in the bipolar PRF group and 12 patients (48.0%) in the monopolar PRF group reported successful pain relief (pain relief of ≥50%).Conclusion:The use of bipolar PRF on the DRG can be an effective and safe interventional technique for chronic refractory lumbosacral radiculopathy, particularly in patients whose pain are refractory to epidural steroid injection or monopolar PRF stimulation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison between bipolar pulsed radiofrequency and monopolar pulsed radiofrequency in chronic lumbosacral radicular pain

2017

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“…Pulsed radiofrequency is applied with temperature limitation at 42 o Celsius and exposure time of at least 120 seconds 37,38 . b) Spinal cord stimulation In patients with pharmacological treatment limitation and insatisfactory response to percutaneous interventionist treatment, the surgical option is spinal electrode implant to stimulate spinal cord above the conus.…”

Section: Acute Lumbar Radiculopathy With Motor Preservation A) Foramimentioning

confidence: 99%

Low back pain

Stump¹,

Kobayashi²,

Campos³

2016

Revista Dor

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“…Only a few randomized controlled trials are known that compared PRF as a treatment with other modalities in chronic LRP . In one randomized controlled trial, 70% of patients with LRP receiving PRF reported a significant reduction in pain (≥2 points and/or ≥30% decrease in VAS score) at 2 months, whereas a significant reduction in pain was found in 82% of patients receiving a combination of PRF and CRF at the same time interval.…”

Section: Discussionmentioning

confidence: 99%

“…Also, recent trials have reported beneficial effects of both PRF alone and PRF in combination with CRF for the management of chronic LRP . Recent studies have demonstrated the efficacy of PRF of the DRG alone or in combination with TF epidural steroid injections in the treatment of LRP …”

Section: Introductionmentioning

confidence: 99%

Transforaminal Epidural Injection of Local Anesthetic and Dorsal Root Ganglion Pulsed Radiofrequency Treatment in Lumbar Radicular Pain: A Randomized, Triple‐Blind, Active‐Control Trial

Mohan

Bhoi

et al. 2019

Pain Practice

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Background Lumbar radicular pain (LRP) results from inflammation and irritation of lumbar spinal nerves and the dorsal root ganglion (DRG). Methods Our study is a prospective, triple‐blind, randomized, activecontrol trial (CTRI/2016/02/006666) comparing transforaminal epidural local anesthetic (LA) injection and pulsed radiofrequency treatment of DRG in patients with chronic LRP. Patients with LRP after failed conservative management for >3 months received selective diagnostic nerve root block with 1 mL 2% lidocaine. Fifty patients showing positive responses were divided into groups of 25 each. The LA group received transforaminal epidural injection of 1 mL 0.5% bupivacaine. The lumbar pulsed radiofrequency (LPRF) group received transforaminal epidural injection of 1 mL 0.5% bupivacaine with 3 cycles of pulsed radiofrequency of the DRG for 180 seconds Results Both groups were compared by observing pain intensity on a 0‐ to 100‐point VAS and improvement in functional status by the Oswestry Disability Index (ODI version 2.0) at 2 weeks and 1, 2, 3, and 6 months. All baseline variables were comparable between the 2 groups. Statistically significant reduction in both outcomes was seen in the LPRF group compared to the LA group from 2 weeks to 6 months. One hundred percent of patients in the LPRF group had a ≥20‐ point decrease in VAS and significant percentage reduction in ODI at all time intervals up to 6 months, whereas it was seen in 80% and 28% of patients in the LA group at 3 and 6 months, respectively. No complications were seen in any patients Conclusion Pulsed radiofrequency of the DRG applied for longer duration results in long‐term pain relief and improvement in the functional quality of life in patients with chronic LRP.

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Treatment of Chronic Lumbosacral Radicular Pain Using Adjuvant Pulsed Radiofrequency: A Randomized Controlled Study

Abstract: The TFEI provided significant short-term pain relief and PRF can be applied in conjunction with TFEI to achieve higher treatment efficacy compared with TFEI alone.

Cited by 76 publications

References 32 publications

Comparison between bipolar pulsed radiofrequency and monopolar pulsed radiofrequency in chronic lumbosacral radicular pain

Comparison between bipolar pulsed radiofrequency and monopolar pulsed radiofrequency in chronic lumbosacral radicular pain

Low back pain

Transforaminal Epidural Injection of Local Anesthetic and Dorsal Root Ganglion Pulsed Radiofrequency Treatment in Lumbar Radicular Pain: A Randomized, Triple‐Blind, Active‐Control Trial

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