Percutaneous pulsed radiofrequency treatment of dorsal root ganglion for treatment of lumbar facet syndrome
| Autor: | Medhat Elsawy, Wael Khedr, Wael Mohamed Mohamed Moussa |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Facet (geometry) Percutaneous Adolescent Radiofrequency ablation medicine.drug_class Zygapophyseal Joint Facet joint law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Double-Blind Method Dorsal root ganglion law Ganglia Spinal medicine Humans Pain Management Prospective Studies Aged Pain Measurement Denervation Lumbar Vertebrae business.industry Local anesthetic Syndrome General Medicine Middle Aged Pulsed Radiofrequency Treatment Surgery Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Female Neurology (clinical) business Low Back Pain 030217 neurology & neurosurgery |
| Zdroj: | Clinical Neurology and Neurosurgery. 199:106253 |
| ISSN: | 0303-8467 |
| DOI: | 10.1016/j.clineuro.2020.106253 |
| Popis: | Objectives Percutaneous radiofrequency denervation of the medial dorsal branch is often used for treatment of chronic low back pain originating from intervertebral facets, which is sometimes associated with a low success rate and a higher incidence of recurrence of pain. We theorized that implementing pulsed radiofrequency treatment to dorsal root ganglion would increase the probability of successful pain relief. Patients and Methods 150 patients diagnosed with CLBP of a confirmed facet origin were included in a prospective randomized controlled trial and were randomly divided into three equal groups, the first was submitted to percutaneous pulsed radiofrequency treatment of the dorsal root ganglia, the second underwent percutaneous radiofrequency denervation of the medial dorsal branch and the third was a control group that did not receive any radiofrequency treatment. Local injection of a mixture of local anesthetic and a steroid was given to the three groups. Cases were followed for a maximum of 3 years. Results 98 (65.3 %) patients were females. By 3 months' post procedure, improvement in VAS was significantly better than pretreatment levels in all groups (p= 0.026); the pulsed radiofrequency treatment group, however, had significantly better incidence of improvement when compared to the other two groups (p= 0.014).The control group lost improvement by 1-year follow-up (p=0.63). At 2 years' follow-up, the pulsed radiofrequency treatment of the dorsal root ganglia group maintained significant improvement (p= 0.041) whereas the medial branch denervation group lost its significant effect (p=0.32).By the end of follow-up period, only pulsed radiofrequency treatment of the dorsal root ganglia group kept significant improvement (p=0.044). Conclusion In CLBP of facet origin, pulsed radiofrequency treatment of the dorsal root ganglia provides both a higher incidence as well as an extended period of pain relief compared to radiofrequency ablation of the medial dorsal branch of the facet joint. |
| Databáze: | OpenAIRE |
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