Department of Anesthesiology and Pain Medicine, Daegu Wooridul Spine Hospital, Daegu, South Korea.
Department of Neurosurgery, Wooridul Spine Hospital, Seoul, South Korea.
Pain Med. 2019 Sep 1;20(9):1697-1701. doi: 10.1093/pm/pnz028.
Radicular pain is related to lesions that either directly compromise the dorsal root ganglion (DRG) or indirectly compromise the spinal nerve and its roots by causing ischemia or inflammation of the axons.
Our study aimed to assess the outcomes of pulsed readiofrequency treatment (PRF) according to electrodiagnosis results in patients with chronic intractable lumbosacral radicular pain.
A total of 82 failed back surgery syndrome (FBSS) patients were included in this study. All of them underwent electromyography/nerve conduction studies before pulsed radiofrequency (PRF) treatment at the DRG, and they were classified according to the electrodiagnostic results as: group 1, no definite finding (normal); group 2, radiculopathy; and group 3, neuropathy. Pain intensity was assessed according to a numeric rating scale score and the Oswestry Disability Index (ODI) before treatment and at one, three, six, and 12 months after treatment, and successful treatment was defined as a pain score reduction of ≥50% at 12 months, as compared with the pretreatment score.
Pretreatment electrodiagnosis identified 28 patients with no definite findings, 31 patients with radiculopathy, and 23 patients with neuropathy. The patients with neuropathy had less pain relief after treatment than those with no definite findings and those with radiculopathy. The prevalence of pain reduction of at least 50% was lower in the neuropathy group than in the other groups. There was no statistically significant difference in ODI between group.
Outcomes after PRF at the DRG did not show strong differences according to electrodiagnostic findings in FBSS patients with chronic intractable lumbosacral radicular pain.
根性疼痛与直接损害背根神经节（DRG）或通过引起轴突缺血或炎症间接损害脊神经及其根的病变有关。
我们的研究旨在评估根据慢性难治性腰骶神经根痛患者的电诊断结果，脉冲射频治疗（PRF）的结果。
共有 82 例失败的腰椎手术综合征（FBSS）患者纳入本研究。所有患者在接受 DRG 脉冲射频（PRF）治疗前均接受肌电图/神经传导研究，并根据电诊断结果分为：1 组，无明确发现（正常）；2 组，根性病变；3 组，神经病。治疗前、治疗后 1、3、6 和 12 个月，根据数字评分量表评分和 Oswestry 残疾指数（ODI）评估疼痛强度，将治疗后 12 个月疼痛评分较治疗前降低≥50%定义为治疗成功。
治疗前电诊断发现 28 例无明确发现，31 例根性病变，23 例神经病。治疗后神经病患者疼痛缓解程度低于无明确发现患者和根性病变患者。疼痛缓解率至少为 50%的神经病患者比例低于其他两组。各组间 ODI 无统计学差异。
在慢性难治性腰骶神经根痛的 FBSS 患者中，DRG 处的 PRF 治疗结果根据电诊断结果没有显示出明显的差异。
