Teixeira Alexandre, Sluijter Menno E
Clinica de Dor, Porto, Portugal.
Pain Med. 2006 Sep-Oct;7(5):424-8. doi: 10.1111/j.1526-4637.2006.00138.x.
Intradiscal radiofrequency, with the electrode placed in the center of the nucleus pulposus, has been a controversial procedure in patients with discogenic pain. Possibly the effect has not been due to the production of heat, but to exposure to electric fields.
We have investigated the effect of high-voltage, long-duration intradiscal pulsed radiofrequency in patients with one-level discogenic low back pain, as confirmed by discography.
The pain intensity score on a 0-10 numeric rating scale (NRS) was taken as outcome measure.
Eight patients were reported. The mean duration of pain was 6.3 years (range 0.5-16, median 4). The mean NRS score was 7.75 (range 5-9). Disc height was reduced 60% in one patient and up to 30% in the others.
A 15-cm, 20-gauge needle with a 15-mm active tip was placed centrally in the disc. Pulsed radiofrequency was applied for 20 min at a setting of 2 x 20 ms/s and 60 V.
There was a very significant fall in the NRS scores over the first 3 months (P < 0.0001). On an individual basis, all patients had a fall of the NRS score of at least 4 points at the 3-month follow-up. A follow-up of 12.8 months (range 6-25, median 9) was available for five patients. All these patients are now pain free, except for one patient with an NRS score of 2. Conclusion. It is concluded that this method merits a controlled, prospective study.
椎间盘内射频消融术，即将电极置于髓核中心，在治疗椎间盘源性疼痛患者时一直存在争议。其效果可能并非源于热的产生，而是由于暴露于电场。
我们研究了经椎间盘造影证实的单节段椎间盘源性下腰痛患者接受高压、长时间椎间盘内脉冲射频消融术的效果。
采用0至10分数字评分量表（NRS）的疼痛强度评分作为观察指标。
报告了8例患者。疼痛平均持续时间为6.3年（范围0.5至16年，中位数4年）。NRS平均评分为7.75分（范围5至9分）。1例患者椎间盘高度降低60%，其他患者降低达30%。
将一根15厘米长、20号的针，其有效尖端为15毫米，置于椎间盘中心。以2×20毫秒/秒和60伏的设置施加脉冲射频20分钟。
在最初3个月内，NRS评分显著下降（P<0.0001）。就个体而言，所有患者在3个月随访时NRS评分至少下降4分。5例患者可进行12.8个月（范围6至25个月，中位数9个月）的随访。除1例NRS评分为2分的患者外，所有这些患者现在均无疼痛。结论：得出结论，该方法值得进行对照的前瞻性研究。
