Tekin Idil, Mirzai Hasan, Ok Gulay, Erbuyun Koray, Vatansever Dilek
Departments of Anesthesiology, Medical Faculty of Celal Bayar University, Manisa, Turkey.
Clin J Pain. 2007 Jul-Aug;23(6):524-9. doi: 10.1097/AJP.0b013e318074c99c.
The goal of this study was to compare the effects of conventional radiofrequency (CRF) and pulsed RF (PRF) denervation to medial branches of dorsal rami in the treatment of facet joint pain.
The patients greater than 17-year old, with continuous low back pain with or without radiating pain with focal tenderness over the facet joints, pain on hyperextension, absence of neurologic defect, unresponsiveness to conservative treatment, no radicular syndrome, and no indication for low back surgery were included in the study. Local anesthetic was applied in the control group (n=20), whereas 80 degrees C CRF were applied in the CRF (n=20) and 2 Hz PRF were applied in the PRF group (n=20). Pain relief was evaluated by visual analog scale (VAS) and Oswestry Disability Index (ODI) at preprocedure, at procedure, at 6 months and 1 year after the procedure. Reduction in analgesic usage, patients' satisfaction, and complications were assessed.
Mean preprocedural VAS and ODI scores were higher than postprocedural scores in all groups. Both VAS and ODI scores of PRF and CRF groups were lower than the score of the control group at the postprocedural evaluation. Although decrease the pain score was maintained in the CRF group at 6 months and 1-year period, this decrease discontinued in the PRF group at the follow-up periods. The number of patients not using analgesics and patient satisfaction were highest in CRF group.
PRF and CRF are effective and safe alternatives in the treatment of facet joint pain but PRF is not as long lasting as CRF.
本研究旨在比较传统射频（CRF）和脉冲射频（PRF）去神经支配背侧支内侧支治疗小关节疼痛的效果。
纳入年龄大于17岁、持续下腰痛伴或不伴放射痛、小关节处有局部压痛、后伸时疼痛、无神经功能缺损、对保守治疗无反应、无神经根综合征且无腰椎手术指征的患者。对照组（n = 20）应用局部麻醉，CRF组（n = 20）应用80℃的CRF，PRF组（n = 20）应用2Hz的PRF。在术前、术中、术后6个月和1年时，通过视觉模拟量表（VAS）和Oswestry功能障碍指数（ODI）评估疼痛缓解情况。评估镇痛药物使用的减少情况、患者满意度和并发症。
所有组术前VAS和ODI平均评分均高于术后评分。术后评估时，PRF组和CRF组的VAS和ODI评分均低于对照组。虽然CRF组在6个月和1年期间疼痛评分持续降低，但PRF组在随访期间疼痛评分下降停止。CRF组不使用镇痛药物的患者数量和患者满意度最高。
PRF和CRF是治疗小关节疼痛有效且安全的替代方法，但PRF的效果不如CRF持久。
