Pulsed Radiofrequency Relieves Low Back Pain, Sciatica

Image-guided pulsed radiofrequency treatment provides relief from low back pain and sciatica, according to a study presented at RSNA.

Researchers from Italy performed a prospective study to determine the clinical impact of CT-guided pulsed radiofrequency in the management of patients with acute or sub-acute neuro-radicular pain from lumbar disc herniation, that did not respond to usual therapeutic strategies.

Eighty patients who presented with acute or sub-acute EMG confirmed neuro-radicular low back pain, unresponsive to usual medications and injections, underwent a pulsed radiofrequency procedure performed with a 22-20 G needle-electrode with probe tip directed to the symptomatic DRG under CT guidance; E-pulsed radiofrequency (Cosman G4) was administered for 10 minutes at 45V with constant local temperature of 42°C. Clinical evaluation was conducted with Visual Analogue Scale (VAS), Owestry Disability Index (ODI), and Roland-Morris (RM) score for quality of life assessment. The subjects completed questionnaires at baseline and then again one week, one month, and three months after the procedure.

The results showed that patients who underwent the treatment showed improvement and decreases in scores overall:

Overall, 90.0% of patients reached a 0 VAS score within the first month after treatment; 97.5% of patients had a decrease of at least 20 points in ODI score in the same interval. Six patients were partial responders and they required a second PRF session. No patients reported any side effects.

"Following this treatment, inflammation and pain go away. With relaxation of the muscles, the distance between the vertebrae returns," lead investigator Alessandro Napoli, MD, PhD, an interventional radiologist at Sapienza University of Rome, said in a release. "There's a big gap between conservative treatments for disc compression and herniation and surgical repair, which can lead to infection, bleeding and a long recovery period. Evolving technologies like this image-guided treatment may help a substantial number of patients avoid surgery."[[{"type":"media","view_mode":"media_crop","fid":"64663","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_568393750819","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"8278","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 236px; width: 450px; float: right;","title":"Lumbar spine MRI showing vertebra at baseline and 3 months after treatment. ©RSNA 2017","typeof":"foaf:Image"}}]]