Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Korea.
Yeungnam University School of Medicine and College of Medicine, Korea.
Pain Physician. 2018 Mar;21(2):E97-E103.
Patients with lumbosacral radicular pain may complain of persisting pain after monopolar pulsed radiofrequency (PRF) treatment.
We evaluated the effect of bipolar PRF stimulation of the dorsal root ganglion (DRG) in patients with chronic lumbosacral radicular pain who were unresponsive to both monopolar PRF stimulation of the DRG and transforaminal epidural steroid injection (TFESI).
This is a prospective observational study.
The outpatient clinic of a single academic medical center in Korea.
We retrospectively reviewed data from 102 patients who had received monopolar PRF to the DRG for management of lumbosacral radiculopathy. Of these, 32 patients had persistent radicular pain that was scored at least 5 on a numeric rating scale (NRS). Twenty-three of them were included in this study and underwent bipolar PRF of the DRG. The outcomes after the procedure were evaluated using the NRS for radicular pain before treatment and 1, 2, and 3 months after treatment. Successful pain relief was defined as >/= 50% reduction in the NRS score compared with the score prior to treatment. Furthermore, at 3 months after treatment, patient satisfaction levels were examined. Patients reporting very good (score = 7) or good results (score = 6) were considered to be satisfied with the procedure.
The NRS scores changed significantly over time. At 1, 2, and 3 months after bipolar PRF, the NRS scores were significantly reduced compared with the scores before the treatment. Twelve (52.2%) of the 23 patients reported successful pain relief and were satisfied with treatment results 3 months after bipolar PRF. No serious adverse effects were recorded.
A small number of patients were recruited and we did not perform long-term follow-up.
We believe the use of bipolar PRF of the DRG can be an effective and safe interventional technique for chronic refractory lumbosacral radiculopathy. It appears to be a potential option that can be tried before proceeding to spinal surgery.
Bipolar, pulsed radiofrequency, lumbosacral radicular pain, chronic pain, dorsal root ganglion, spinal stenosis, herniated disc.
腰骶神经根痛患者在接受单极脉冲射频（PRF）治疗后可能会持续疼痛。
我们评估了对双侧 PRF 刺激背根神经节（DRG）治疗对双侧 PRF 刺激背根神经节（DRG）和经椎间孔硬膜外类固醇注射（TFESI）均无反应的慢性腰骶神经根痛患者的影响。
这是一项前瞻性观察性研究。
韩国一家学术医学中心的门诊诊所。
我们回顾性分析了 102 例接受 DRG 单极 PRF 治疗腰骶神经根病患者的数据。其中 32 例有持续性神经根痛，疼痛评分至少为数字评分量表（NRS）的 5 分。其中 23 例患者纳入本研究，并接受 DRG 双侧 PRF 治疗。治疗后通过 NRS 评估治疗前后及治疗后 1、2、3 个月的神经根痛。疼痛缓解定义为与治疗前评分相比，NRS 评分降低≥50%。此外，还在治疗后 3 个月评估了患者的满意度水平。报告非常好（评分=7）或满意（评分=6）的患者被认为对该治疗过程满意。
NRS 评分随时间显著变化。治疗后 1、2、3 个月，NRS 评分明显低于治疗前。23 例患者中有 12 例（52.2%）报告疼痛缓解成功，且在治疗后 3 个月对治疗结果满意。无严重不良事件发生。
入组患者数量较少，且我们未进行长期随访。
我们认为双侧 DRG PRF 可作为治疗慢性难治性腰骶神经根病的一种有效且安全的介入技术。在进行脊柱手术之前，它似乎是一种潜在的选择。
双极、脉冲射频、腰骶神经根痛、慢性疼痛、背根神经节、椎管狭窄、椎间盘突出。
