椎间盘内脉冲射频应用时间对腰椎间盘源性下腰痛的影响。

Intradiscal Pulsed Radiofrequency Application Duration Effect on Lumbar Discogenic Low Back Pain.

机构信息

Daegu Wooridul Spine Hospital, Jung-Gu, Daegu, Republic of Korea.

Wooridul Spine Hospital, Korea.

出版信息

Pain Physician. 2020 Sep;23(5):E535-E540.

PMID:32967404

Abstract

BACKGROUND

Discogenic pain is recognized as the most important and most common cause of low back pain (LBP). Intradiscal pulsed radiofrequency (ID-PRF) is used for the treatment of chronic discogenic pain.

OBJECTIVES

We investigated the effects of the duration of percutaneous monopolar ID-PRF application on chronic discogenic LBP.

STUDY DESIGN

Retrospective study.

SETTING

Department of Anesthesiology and Pain Medicine, Neurosurgery at Wooridul Spine Hospital.

METHODS

Forty-five patients were included in this retrospective study. The patients were assigned into 2 groups according to the duration of the PRF procedure they underwent (7-minute group = 17 patients vs. 15-minute group = 28 patients). The main outcome measures tested were pain score, as determined by the Numeric Rating Scale (NRS-11) and the Oswestry Disability Index (ODI), at baseline, at 2-week, and 6-month follow-up visits. Success was defined as a reduction in NRS-11 of 50% or more or an ODI reduction of 40% or more.

RESULTS

The mean posttreatment pain scores at 2 weeks and 6 months were significantly lower (P < 0.05) in both groups, but the differences between the groups were not significant. ODI scores were also significantly lower compared with the baseline, but the differences between the groups were not significant. At the 6-month follow-up, 12 patients (70.6%) in the 7-minute group and 20 patients (71.4%) in the 15-minute group reported more than 50% reduction in the pain score (P = 0.16), and there was no significant difference between the 2 groups in the number of patients with more than 40% reduction in ODI score (P = 0.23).

LIMITATIONS

This study was performed with a small sample size and there was no control group. Additional well-designed and well-controlled studies that include parameters such as the stimulation duration, mode, and intensity of PRF are needed to fully assess the efficiency of ID-PRF.

CONCLUSIONS

ID-PRF was shown to be effective for the treatment of discogenic LBP regardless of duration of ID-PRF application (7 vs. 15 minutes).

摘要

背景

椎间盘源性疼痛被认为是导致下腰痛（LBP）的最重要和最常见的原因。经皮单极椎间盘内脉冲射频（ID-PRF）用于治疗慢性椎间盘源性腰痛。

目的

我们研究了经皮单极 ID-PRF 应用时间长短对慢性椎间盘源性 LBP 的影响。

研究设计

回顾性研究。

设置

蔚山脊柱医院麻醉与疼痛医学系，神经外科。

方法

本回顾性研究纳入 45 例患者。根据 PRF 治疗时间长短将患者分为 2 组（7 分钟组=17 例与 15 分钟组=28 例）。主要观察指标为基线、2 周和 6 个月随访时的疼痛评分（NRS-11 评分和 Oswestry 残疾指数（ODI））。疗效定义为 NRS-11 评分降低 50%或以上或 ODI 评分降低 40%或以上。

结果

两组治疗后 2 周和 6 个月时的平均疼痛评分均显著降低（P < 0.05），但组间差异无统计学意义。ODI 评分也较基线显著降低，但组间差异无统计学意义。6 个月随访时，7 分钟组 12 例（70.6%）和 15 分钟组 20 例（71.4%）患者疼痛评分降低 50%以上（P = 0.16），两组 ODI 评分降低 40%以上的患者比例无显著差异（P = 0.23）。