Department of Neurosurgery, University Medical Center, Ho Chi Minh City, Vietnam.
Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
PLoS One. 2024 Apr 4;19(4):e0292042. doi: 10.1371/journal.pone.0292042. eCollection 2024.
BACKGROUND: Lumbosacral radicular syndrome (LRS) is probably the most frequent neuropathic pain syndrome, exaggerating medical and economy burden on developing countries, such as Vietnam. As a result, the urgence to find an approach which is both affordable and effective always puts great demand on medical researchers. OBJECTIVES: Evaluate the effectiveness of transforaminal pulsed radiofrequency (PRF) stimulation on the dorsal root ganglion (DRG) and epidural steroid injection (ESI) in management of chronic lumbosacral radiculopathy. METHODS: Seventy-six patients with chronic radicular pain were performed transforaminal PRF + ESI by neurosurgeons. Demographic characteristics and surgical outcomes were recorded on admission, pre-procedural and post-procedural for 1-month, 3-month, 6-month and 12-month follow-up. Primary outcome was measured by using Visual Analogue Scale (VAS), Oswestry disability index (ODI) and Straight Leg Raising Test (SLRT). Secondary outcome was subjectively collected based on short assessment of patients' satisfaction (SAPS). RESULTS: Patients who received transforaminal PRF and ESI showed significant improvements on all three evaluation tools (VAS, ODI, SLRT), compared to that before treatment (p<0.001). Pain relief was achievable and long-lasting, which met patients' expectation. No significant complications were observed for 12 months follow-up. CONCLUSION: Transforaminal PRF combined with ESI in management of lumbosacral radiculopathy should be a good method of choice for its effectiveness and safety in management of pain.
背景:腰骶神经根综合征(LRS)可能是最常见的神经性疼痛综合征,给发展中国家(如越南)带来了沉重的医疗和经济负担。因此,迫切需要找到一种既负担得起又有效的方法,这对医学研究人员提出了很高的要求。
目的:评估经椎间孔脉冲射频(PRF)刺激背根神经节(DRG)和硬膜外类固醇注射(ESI)治疗慢性腰骶神经根病变的疗效。
方法:神经外科医生对 76 例慢性根性疼痛患者进行了经椎间孔 PRF+ESI。记录人口统计学特征和手术结果,在入院时、术前和术后 1 个月、3 个月、6 个月和 12 个月进行随访。主要结果采用视觉模拟评分(VAS)、Oswestry 残疾指数(ODI)和直腿抬高试验(SLRT)进行测量。次要结果根据患者满意度的简短评估(SAPS)进行主观收集。
结果:与治疗前相比,接受经椎间孔 PRF 和 ESI 治疗的患者在所有三种评估工具(VAS、ODI、SLRT)上均有显著改善(p<0.001)。疼痛缓解是可实现的和持久的,符合患者的期望。在 12 个月的随访中未观察到明显的并发症。
结论:经椎间孔 PRF 联合 ESI 治疗腰骶神经根病变,在疼痛管理方面具有有效性和安全性,应是一种较好的治疗方法。
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