Do Kyung Hee, Ahn Sang Ho, Cho Yun Woo, Chang Min Cheol
Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul Dr Ahn's Spine & Pain Clinic, and Dr Ahn's Spine and Pain Institute, Daegu, Republic of Korea.
Medicine (Baltimore). 2017 Mar;96(13):e6524. doi: 10.1097/MD.0000000000006524.
BACKGROUND: This study aimed to demonstrate the effect of intra-articular (IA) lumbar facet joint (LFJ) pulsed radiofrequency (PRF) for the management of LFJ pain, and to compare the effect of IA LFJ PRF to IA corticosteroid injection (ICI). Pathology in the LFJ is a common source of lower back pain (LBP). It is responsible for chronic LBP in approximately 15% to 45% of patients. It has been reported that PRF stimulation can effectively reduce refractory joint pain. METHODS: Sixty patients with LFJ pain were recruited and randomly assigned to 1 of 2 groups: the IA PRF group and the ICI group. There were 30 patients in each group. At pretreatment, 2 weeks, 1, 3, and 6 months after treatment, we assessed the severity of LBP using a numeric rating scale (NRS). RESULTS: Compared with the pretreatment NRS scores, patients in both groups showed a significant decrease in NRS scores at 2 weeks, and 1, 3, and 6 months after each treatment. Between groups, changes in the NRS scores were significantly different over time. At 2 weeks and 1 month after each procedure, the NRS score after ICI was significantly lower than that after the PRF stimulation. However, at 3 and 6 months after the procedures, the decrements of NRS scores were not significantly different between the 2 groups. Six months after treatment, about half of patients in both groups reported successful pain relief (pain relief of ≥50%). CONCLUSION: In the current study, both IA PRF stimulation and ICI into the LFJ significantly relieved LFJ pain. Their effects persisted for at least 6 months after the procedure. Thus, IA PRF is a useful therapeutic option for the management of LFJ pain.
背景:本研究旨在证明关节内(IA)腰椎小关节(LFJ)脉冲射频(PRF)治疗LFJ疼痛的效果,并比较IA LFJ PRF与IA皮质类固醇注射(ICI)的效果。LFJ病变是下腰痛(LBP)的常见原因。它导致约15%至45%的患者出现慢性LBP。据报道,PRF刺激可有效减轻顽固性关节疼痛。 方法:招募60例LFJ疼痛患者,随机分为2组:IA PRF组和ICI组。每组30例患者。在治疗前、治疗后2周、1、3和6个月,我们使用数字评分量表(NRS)评估LBP的严重程度。 结果:与治疗前NRS评分相比,两组患者在每次治疗后2周、1、3和6个月时NRS评分均显著降低。组间比较,NRS评分随时间的变化有显著差异。在每次治疗后2周和1个月时,ICI后的NRS评分显著低于PRF刺激后的评分。然而,在治疗后3个月和6个月时,两组间NRS评分的下降幅度无显著差异。治疗6个月后,两组中约一半的患者报告疼痛得到有效缓解(疼痛缓解≥50%)。 结论:在本研究中,IA PRF刺激和向LFJ内注射ICI均能显著缓解LFJ疼痛。其效果在治疗后至少持续6个月。因此,IA PRF是治疗LFJ疼痛的一种有效治疗选择。
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