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经椎间孔硬膜外类固醇注射联合背根神经节脉冲射频治疗是否能提高疗效?

Does transforaminal epidural steroid injection added to dorsal root ganglion pulsed radiofrequency treatment increase efficacy?

作者信息

Yildiz Gokhan, Goksu Hamit, Akcaboy Erkan Yavuz, Celik Seref, Ayhan Mustafa Yemliha, Kaya Samet Sancar

机构信息

Department of Algology, Ankara Etlik City Hospital, Ankara, Türkiye.

Department of Algology, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Türkiye.

出版信息

Turk J Phys Med Rehabil. 2024 Jul 26;70(3):390-396. doi: 10.5606/tftrd.2024.13479. eCollection 2024 Sep.

Abstract

OBJECTIVES

This study aimed to compare the treatment outcomes between dorsal root ganglion (DRG) pulsed radiofrequency (PRF) and DRG PRF plus transforaminal epidural steroid injection (TFESI) in patients with chronic lumbosacral radicular pain.

PATIENTS AND METHODS

Eighty-one patients (39 males, 42 females; mean age: 57.5±11.9 years; range 18 to 65 years) who underwent DRG PRF (Group 1) and 59 patients (34 males, 25 females; mean age: 58.7±12.3 years; range 18 to 65 years) who underwent DRG PRF plus TFESI (Group 2) between February 2021 and June 2022 were enrolled in the retrospective study. A Visual Analog Scale (VAS) was used to assess pain severity. Patients in both groups were evaluated before treatment and at four weeks and six months after treatment.

RESULTS

The four-week and six-month VAS scores were significantly lower than the baseline VAS scores in both groups. There was no significant difference between the groups in terms of the VAS scores at baseline, four weeks, and six months. There was no significant difference between the groups in terms of the rate of pain reduction of 50% or more at either measurement point. The presence or absence of a previous lumbar surgery had no effect on achieving a significant decrease in pain.

CONCLUSION

Although DRG PRF and TFESI are easy to apply together, adding corticosteroids to DRG PRF treatment for patients with chronic radicular pain did not improve long-term outcomes.

摘要

目的

本研究旨在比较背根神经节(DRG)脉冲射频(PRF)与DRG脉冲射频联合经椎间孔硬膜外类固醇注射(TFESI)治疗慢性腰骶神经根性疼痛患者的疗效。

患者与方法

对2021年2月至2022年6月期间接受DRG脉冲射频治疗的81例患者(男39例,女42例;平均年龄:57.5±11.9岁;年龄范围18至65岁)(第1组)和接受DRG脉冲射频联合TFESI治疗的59例患者(男34例,女25例;平均年龄:58.7±12.3岁;年龄范围18至65岁)(第2组)进行回顾性研究。采用视觉模拟评分法(VAS)评估疼痛严重程度。两组患者在治疗前、治疗后4周和6个月进行评估。

结果

两组患者治疗后4周和6个月的VAS评分均显著低于基线VAS评分。两组患者在基线、4周和6个月时的VAS评分无显著差异。在任一测量点,两组患者疼痛减轻50%或更多的比例无显著差异。既往是否接受过腰椎手术对疼痛显著减轻无影响。

结论

尽管DRG脉冲射频和TFESI易于联合应用,但在DRG脉冲射频治疗慢性神经根性疼痛患者时添加皮质类固醇并不能改善长期疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c652/11639494/50db482e0386/TJPMR-2024-70-3-390-396-F1.jpg

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