Jandura Jiri, Vajda Milan, Kostysyn Roman, Vanasek Jiri, Cermakova Eva, Zizka Jan, Ryska Pavel
Department of Diagnostic Radiology, University Hospital Hradec Kralove, Sokolska 581, 50005 Hradec Kralove, Czech Republic.
Department of Diagnostic Radiology, Faculty of Medicine in Hradec Kralove, Charles University, Simkova 870, 50003 Hradec Kralove, Czech Republic.
J Pers Med. 2023 Jun 27;13(7):1054. doi: 10.3390/jpm13071054.
Chronic lumbosacral radicular pain (CLRP) as a possible adverse consequence of lumbar spine surgery represents a serious medical challenge. Pulsed radiofrequency of dorsal root ganglion (PRF-DRG) treatment is known to be effective in alleviating CLRP. This retrospective study compares the efficacy of a single CT-guided PRF-DRG procedure in the treatment of unilateral CLRP between patients without (non-PSS) and with (PSS) previous lumbar spine surgery. Non-PSS and PSS groups included 30 and 20 patients, respectively. Outcomes (pain intensity and disability) were evaluated by means of the visual analog scale (VAS) and Oswestry disability index (ODI) immediately after the procedure (VAS), as well as three and six months after the procedure, respectively. Non-PSS group showed a significant ( ˂ 0.001) decrease of VAS (median) at all follow-up intervals (from 6 to 4; 4; 4.5 points, respectively). The PSS group showed a significant yet transient VAS (median) decrease (from 6 to 5 points) immediately after the procedure only ( < 0.001). The decrease of VAS was more pronounced in the non-PSS group after three and six months ( = 0.0054 and 0.011, respectively) in intergroup comparison. A relative decrease of VAS ≥ 50% during follow-up was achieved in 40%; 43.3%; 26.7% (non-PSS), and 25%; 5%; 0% (PSS) of patients. ODI (median) significantly decreased in the non-PSS group (from 21.5 to 18 points) at three and six months ( = 0.014 and 0.021, respectively). In conclusion, previous lumbar spine surgery decreases the therapeutic efficacy of PRF-DRG procedure in CLRP patients.
慢性腰骶部神经根性疼痛（CLRP）作为腰椎手术可能的不良后果，是一项严峻的医学挑战。已知背根神经节脉冲射频（PRF-DRG）治疗在缓解CLRP方面有效。本回顾性研究比较了在无（非PSS）和有（PSS）既往腰椎手术史的患者中，单次CT引导下PRF-DRG手术治疗单侧CLRP的疗效。非PSS组和PSS组分别纳入30例和20例患者。分别在术后即刻（VAS）以及术后3个月和6个月，通过视觉模拟量表（VAS）和Oswestry功能障碍指数（ODI）评估结果（疼痛强度和功能障碍）。非PSS组在所有随访间隔时VAS（中位数）均显著降低（˂0.001）（分别从6分降至4分、4分、4.5分）。PSS组仅在术后即刻VAS（中位数）有显著但短暂的降低（从6分降至5分）（˂0.001）。组间比较时，术后3个月和6个月非PSS组VAS降低更明显（分别为=0.0054和0.011）。随访期间VAS相对降低≥50%的患者比例在非PSS组为40%、43.3%、26.7%，在PSS组为25%、5%、0%。非PSS组在术后3个月和6个月时ODI（中位数）显著降低（分别从21.5降至18分）（分别为=0.014和0.021）。总之，既往腰椎手术会降低PRF-DRG手术对CLRP患者的治疗效果。
