Department of Anesthesiology and Pain Medicine, School of Medicine Daegu Catholic University, Daegu, Republic of Korea.
Medicine (Baltimore). 2022 Feb 11;101(6):e28831. doi: 10.1097/MD.0000000000028831.
Discogenic low back pain often persists despite medication and medical intervention. In this study, intradiscal pulsed radiofrequency (PRF) was performed in a patient with discogenic low back pain who did not respond to oral medication, posterior medial branch block, epidural steroid injection, and percutaneous epidural adhesiolysis.
A 28-year-old woman visited a pain clinic complaining of low back pain that was scored 8 out of 10 on a numerical rating scale. Her pain was present in any position throughout the day and worsened in the sitting position.
Magnetic resonance imaging showed L5-S1 internal discal disruption. Based on the medical history, physical examination, and magnetic resonance imaging, we determined that her pain originated from the L5-S1 disc.
We performed an intradiscal PRF on the affected disc under C-arm fluoroscopy guidance. PRF was performed at 5 Hz, 20-ms pulse width, and 70 V for 15 minutes while ensuring that the electrode tip temperature was maintained below 42°C.
Immediately after the procedure, the patient's pain subsided. At the 1-month follow-up visit, the patient reported complete relief of her low back pain. The Oswestry disability index, which indicates the degree of disability, improved significantly. She also reported that she could sit for long periods because the pain was reduced. No adverse effects from the procedure were found.
Applying intradiscal PRF seems an effective and safe technique for treating discogenic low back pain.
尽管药物和医学干预措施已经应用，但椎间盘源性下腰痛仍常常持续存在。在本研究中，对一位药物治疗、后路内侧支阻滞、硬膜外类固醇注射和经皮硬膜外松解术等治疗均无效的椎间盘源性下腰痛患者进行了椎间盘内脉冲射频（PRF）治疗。
一位 28 岁女性因腰痛至疼痛科就诊，其数字评分量表（NRS）评分为 8 分（满分 10 分）。她全天任何体位均有疼痛，坐位时加重。
磁共振成像（MRI）显示 L5-S1 椎间盘内破裂。根据病史、体格检查和 MRI，我们确定其疼痛来源于 L5-S1 椎间盘。
在 C 型臂 X 线透视引导下行椎间盘内 PRF 治疗。PRF 以 5 Hz、20-ms 脉冲宽度和 70 V 进行 15 分钟，同时确保电极尖端温度保持在 42°C 以下。
治疗后即刻患者疼痛缓解。1 个月随访时，患者报告其下腰痛完全缓解。表明其残疾程度的 Oswestry 功能障碍指数（ODI）显著改善。她还报告说疼痛减轻后可以长时间坐位。未发现该治疗有任何不良反应。
椎间盘内 PRF 似乎是治疗椎间盘源性下腰痛的一种有效且安全的技术。
