Department of Neurosurgery, Taichung Veterans General Hospital, Feng Chia University, Taichung, Taiwan, Republic of China.
J Neurosurg Spine. 2010 Feb;12(2):190-6. doi: 10.3171/2009.9.SPINE08946.
The authors assessed the effectiveness of percutaneous pulsed radiofrequency treatment for providing pain relief in patients with chronic low-back pain with or without lower-limb pain.
Data were obtained in 127 patients who had chronic low-back pain with or without lower-limb pain due to a herniated intervertebral disc or previous failed back surgery and who underwent pulsed radiofrequency treatment. Their conditions were proven by clinical features, physical examination, and imaging studies. Low-back pain was treated with pulsed radiofrequency applied to the L-2 dorsal root ganglion (DRG) and lower-limb pain was treated with pulsed radiofrequency applied to the L3-S1 DRG. Patients underwent uni- or bilateral treatment depending on whether their low-back pain was unilateral or bilateral. A visual analog scale was used to assess pain. The patients were followed up for 3 years postoperatively.
In patients without lower-limb pain (Group A), 27 (55.10%) of 49 patients had initial improvement >or= 50% at 3-month follow-up. At 1-year follow-up, 20 (44.44%) of 45 patients in Group A had pain relief >or= 50%. An analysis of patients with pain relief >or= 50% for at least 1 month showed that the greatest effect was at 3 months after treatment. In patients with low-back pain and lower-limb pain (Group B), 37 (47.44%) of 78 patients had initial improvement >or= 50% at 3-month follow-up. At 1-year follow-up, 34 (45.95%) of 74 patients had pain relief effect >or= 50%. An analysis of patients in Group B with pain relief >or= 50% for at least 1 month showed that the greatest effect was at 1 month after treatment.
The results of this prospective analysis showed that treatment with pulsed radiofrequency applied at the L-2 DRG is safe and effective for treating for chronic low-back pain. Satisfactory pain relief was obtained in the majority of patients in Group A with the effect persisting for at least 3 months. The results indicate that pulsed radiofrequency provided intermediate-term relief of low-back pain. Further studies with long-term follow-up are necessary.
评估经皮脉冲射频治疗对伴有或不伴有下肢疼痛的慢性下腰痛患者的止痛效果。
127 例因椎间盘突出或既往腰椎手术失败而导致慢性下腰痛伴或不伴有下肢疼痛的患者接受了脉冲射频治疗，这些患者的情况通过临床特征、体格检查和影像学研究得到证实。下腰痛采用 L-2 背根神经节（DRG）脉冲射频治疗，下肢痛采用 L3-S1 DRG 脉冲射频治疗。根据下腰痛是单侧还是双侧，患者接受单侧或双侧治疗。采用视觉模拟评分法评估疼痛。术后对患者进行了 3 年的随访。
在无下肢疼痛的患者（A 组）中，49 例患者中有 27 例（55.10%）在 3 个月随访时初始改善>50%。在 1 年随访时，45 例 A 组患者中有 20 例（44.44%）疼痛缓解>50%。对至少 1 个月疼痛缓解>50%的患者进行分析，结果显示治疗后 3 个月效果最佳。在伴有下腰痛和下肢痛的患者（B 组）中，78 例患者中有 37 例（47.44%）在 3 个月随访时初始改善>50%。在 1 年随访时，74 例患者中有 34 例（45.95%）疼痛缓解效果>50%。对 B 组中至少 1 个月疼痛缓解>50%的患者进行分析，结果显示治疗后 1 个月效果最佳。
这项前瞻性分析的结果表明，L-2 DRG 处应用脉冲射频治疗慢性下腰痛是安全有效的。A 组大部分患者疼痛缓解效果满意，至少持续 3 个月。结果表明，脉冲射频可提供慢性下腰痛的中期缓解。需要进一步进行长期随访的研究。
