脉冲射频对慢性难治性颈神经根性疼痛的短期影响

Short-term effects of pulsed radiofrequency on chronic refractory cervical radicular pain.

作者信息

Choi Gyu-Sik, Ahn Sang-Ho, Cho Yun-Woo, Lee Dong-Kyu

机构信息

Department of Rehabilitation Medicine, Yeungnam University College of Medicine, Daegu 705-717, Korea.

出版信息

Ann Rehabil Med. 2011 Dec;35(6):826-32. doi: 10.5535/arm.2011.35.6.826. Epub 2011 Dec 30.

Abstract

OBJECTIVE

To evaluate the short-term effectiveness of pulsed radiofrequency on the dorsal root ganglion (DRG) in patients with chronic refractory cervical radicular pain.

METHOD

Fifteen patients (13 males, 2 females; mean age, 55.9 years) with chronic radicular pain due to cervical disc herniation or foraminal stenosis refractory to active rehabilitative management, including transforaminal cervical epidural steroid injection and exercise, were selected. All patients received pulsed radiofrequency on the symptomatic cervical dorsal root ganglion and were carefully evaluated for neurologic deficits and side effects. The clinical outcomes were measured using a visual analogue scale (VAS) and a neck disability index (NDI) before treatment, one and three months after treatment. Successful pain relief was defined as a 50% or greater reduction in the VAS score as compared with the pre-treatment score. After three months, we categorized the patients' satisfaction.

RESULTS

The average VAS for radicular pain was reduced significantly from 5.3 at pretreatment to 2.5 at 3 months post-treatment (p<0.05). Eleven of 15 patients (77.3%) after cervical pulsed RF stimulation reported pain relief of 50% or more at the 3 month follow-up. The average NDI was significantly reduced from 44.0% at pretreatment to 35.8% 3 months post-treatment (p<0.05). At 3 months post-treatment, eleven of fifteen patients (73.3%) were satisfied with their status. No adverse effects were observed.

CONCLUSION

The results demonstrate that the application of pulsed radiofrequency on DRG might be an effective short-term intervention for chronic refractory cervical radicular pain. Further studies, including a randomized controlled trial with long-term follow-up, are now needed.

摘要

目的

评估脉冲射频治疗对慢性难治性神经根型颈椎病患者背根神经节(DRG)的短期疗效。

方法

选取15例(男13例,女2例;平均年龄55.9岁)因颈椎间盘突出症或椎间孔狭窄导致慢性神经根性疼痛且积极康复治疗(包括经椎间孔颈椎硬膜外类固醇注射和运动疗法)无效的患者。所有患者均接受了针对有症状的颈背根神经节的脉冲射频治疗,并对神经功能缺损和副作用进行了仔细评估。在治疗前、治疗后1个月和3个月使用视觉模拟量表(VAS)和颈部功能障碍指数(NDI)测量临床结果。成功缓解疼痛的定义为VAS评分较治疗前降低50%或更多。3个月后,对患者的满意度进行分类。

结果

神经根性疼痛的平均VAS评分从治疗前的5.3显著降低至治疗后3个月的2.5(p<0.05)。15例患者中有11例(77.3%)在接受颈椎脉冲射频刺激后,在3个月随访时报告疼痛缓解50%或更多。平均NDI从治疗前的44.0%显著降低至治疗后3个月的35.8%(p<0.05)。治疗后3个月,15例患者中有11例(73.3%)对其状况感到满意。未观察到不良反应。

结论

结果表明,对背根神经节应用脉冲射频可能是慢性难治性神经根型颈椎病的一种有效的短期干预措施。现在需要进一步的研究,包括长期随访的随机对照试验。

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