Department of Anesthesiology and Pain Management, Maastricht University Medical Centre, Maastricht, The Netherlands.
Pain Med. 2011 Sep;12(9):1322-30. doi: 10.1111/j.1526-4637.2011.01202.x. Epub 2011 Aug 3.
Lumbosacral radicular syndrome (LRS) is probably the most frequent neuropathic pain syndrome. Three months to 1 year after onset, 30% of the patients still experience ongoing pain. The management of those patients is complex, and treatment success rates are rather low. The beneficial effect of pulsed radiofrequency (PRF) therapy has been described for the treatment of LRS in case reports and in retrospective and prospective studies. Up until now, no neurological complications have been reported after PRF treatment. The current clinical audit has been performed to assess the amount of pain relief after a single PRF treatment.
Sixty consecutive patients who received a PRF treatment adjacent to the lumbar dorsal root ganglion for the management of LRS in the period 2007-2009 were included. The main study objective was to measure the reduction of pain after the pulsed radiofrequency treatment by using the global perceived effect. The primary end point was defined as at least 50% pain relief for a period of 2 months or longer.
The primary end point was achieved in 29.5% of all the PRF interventions. After 6 months, 50% pain relief was still present in 22.9% of the cases and after 12 months in 13.1% of the cases. The need for pain medication was significantly lower after pulsed radiofrequency treatment in the success group compared with the nonsuccess group.
PRF treatment can be considered for the management of LRS patients. These results need to be confirmed in a randomized clinical trial.
腰骶神经根综合征(LRS)可能是最常见的神经性疼痛综合征。在发病后 3 个月至 1 年内,30%的患者仍持续存在疼痛。这些患者的治疗较为复杂,治疗成功率相当低。脉冲射频(PRF)治疗的疗效已在病例报告和回顾性及前瞻性研究中得到描述,可用于治疗 LRS。到目前为止,PRF 治疗后没有报告出现神经并发症。目前进行的临床审计是为了评估单次 PRF 治疗后的止痛效果。
2007 年至 2009 年间,共纳入 60 例连续接受 PRF 治疗的腰骶部背根神经节旁治疗 LRS 的患者。主要研究目的是通过整体感知效果测量 PRF 治疗后的疼痛缓解程度。主要终点定义为至少 50%的疼痛缓解持续 2 个月或更长时间。
所有 PRF 干预中,主要终点的达成率为 29.5%。6 个月后,22.9%的病例仍有 50%的疼痛缓解,12 个月后,13.1%的病例仍有 50%的疼痛缓解。与非成功组相比,成功组在脉冲射频治疗后对止痛药物的需求明显降低。
可以考虑将 PRF 治疗用于治疗 LRS 患者。这些结果需要在随机临床试验中得到证实。