An alternative distal approach for the lumbar medial branch radiofrequency denervation: a prospective randomized comparative study
| Autor: | Yong Chul Kim, Seung Pyo Choi, Jee Youn Moon, Pyung Bok Lee, Woo Seog Sim |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Endpoint Determination Radio Waves medicine.medical_treatment Radiosurgery Zygapophyseal Joint law.invention Disability Evaluation Lumbar Randomized controlled trial law Clinical endpoint medicine Humans Prospective Studies Prospective cohort study Aged Pain Measurement business.industry Lumbosacral Region Nerve Block Middle Aged Low back pain Denervation Confidence interval Surgery Oswestry Disability Index Anesthesiology and Pain Medicine Treatment Outcome Ambulatory Surgical Procedures Anesthesia Sample Size Nerve block Female medicine.symptom business Low Back Pain Anesthesia Local |
| Zdroj: | Anesthesia and analgesia. 116(5) |
| ISSN: | 1526-7598 |
| Popis: | BACKGROUND An alternative technique involving a "distal approach" can be used for lumbar medial branch radiofrequency denervation (LMBRFD). We described and assessed this technique by comparing it with a conventional tunnel vision approach in a prospective randomized trial. METHODS Eighty-two patients underwent LMBRFD by a distal (n = 41) or a tunnel vision approach (n = 41). The primary end point was a comparison of the mean difference in the change of 11-point numeric rating scale (NRS) scores of low back pain from entry to the scores at 1 month (NRS at baseline--NRS at 1 month) and at 6 months (NRS at baseline--NRS at 6 months) between the distal approach group and the tunnel vision approach group. The secondary end points were a change of NRS and the Oswestry disability index over time. RESULTS Thirty-four patients in each group had complete time courses. There were no statistically significant differences in the change of NRS scores between the groups at 1 month (corrected P = 0.19; 97.5% 2-sided confidence interval [CI], -1.37 to 0.37) and 6 months (corrected P = 0.53; 97.5% CI, -1.36 to 0.77). Patients in both groups showed a statistically significant reduction in NRS and Oswestry disability index scores from baseline to that of the scores at 1 and 6 months (all P < 0.0001, Bonferroni corrected). The procedure-related pain score was significantly lower in the distal approach group (P = 0.001; 99% CI, -2.00 to -0.23). CONCLUSIONS Patients who underwent LMBRFD by the tunnel vision or distal approaches showed significant pain relief at the 6-month follow-up. Less periprocedural pain was reported in the distal approach group. We consider that the distal approach provides an improved option for LMBRFD. |
| Databáze: | OpenAIRE |
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