Sansone Pasquale, Giaccari Luca G, Lippiello Antonietta, Aurilio Caterina, Paladini Antonella, Passavanti Maria Beatrice, Pota Vincenzo, Pace Maria Caterina
Department of Women, Children and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Department of Neurosurgery, "Santa Maria delle Grazie Hospital", Pozzuoli, Italy.
Pain Ther. 2020 Dec;9(2):573-582. doi: 10.1007/s40122-020-00187-z. Epub 2020 Aug 8.
Low back pain (LBP) is a common problem, and facet joint pain is responsible for 15-45% of cases. Treatment is multidisciplinary, and when conservative measures are not sufficient, radiofrequency (RF) is often used. It allows the interruption of nociceptive input, producing a heat lesion in a continuous or pulsed mode.
Medical records of 60 patients who underwent pulsed RF denervation were examined. The standard procedure provided follow-up of pain intensity. Numerical rating scale (NRS) and Douleur Neuropathique en 4 Questions (DN4) were recorded before treatment, and 15 and 40 days, and 6 months after treatment. Oswestry Disability Index (ODI) and patient satisfaction were also recorded. Successful treatment was defined as more than a 50% reduction in the NRS scores at 6 months compared with pretreatment scores.
Scores on the NRS and DN4 were statistically different over time (p < 0.05). Scores at 6 months were significantly decreased when compared with pretreatment scores (p < 0.05). ODI scores decreased during the follow-up period. No adverse effect was recorded and 57 patients (97%) reported successful pain relief.
Continuous RF is the gold standard in the management of lumbar facet joint pain. Pulsed RF is a promising technique: patients with chronic LBP who had not responded to conservative care tended to improve after pulsed RF. The procedure was well tolerated in the absence of contraindications, and reliable if the nerve endings regrew.
腰痛（LBP）是一个常见问题，其中小关节疼痛占病例的15 - 45%。治疗是多学科的，当保守措施不足时，常使用射频（RF）。它可中断伤害性输入，以连续或脉冲模式产生热损伤。
检查了60例行脉冲射频去神经术患者的病历。标准程序提供疼痛强度的随访。在治疗前、治疗后15天、40天和6个月记录数字评分量表（NRS）和4项神经病理性疼痛量表（DN4）。还记录了Oswestry功能障碍指数（ODI）和患者满意度。成功治疗定义为与治疗前评分相比，6个月时NRS评分降低超过50%。
NRS和DN4评分随时间有统计学差异（p < 0.05）。与治疗前评分相比，6个月时的评分显著降低（p < 0.05）。随访期间ODI评分降低。未记录到不良反应，57例患者（97%）报告疼痛缓解成功。
连续射频是治疗腰椎小关节疼痛的金标准。脉冲射频是一种有前景的技术：对保守治疗无反应的慢性腰痛患者在接受脉冲射频治疗后往往有所改善。在没有禁忌证的情况下，该操作耐受性良好，如果神经末梢再生则效果可靠。
