CT-Pulsed Radiofrequency May Be Effective for Acute Neuroradicular Low Back Pain

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Computed tomography-pulsed radiofrequency may “avoid surgery for a substantial number of patients with sciatic disc compression.”
Computed tomography-pulsed radiofrequency may “avoid surgery for a substantial number of patients with sciatic disc compression.”

Computed tomography (CT)-pulsed radiofrequency may represent an effective management strategy for patients with acute or subacute neuroradicular low back pain that is refractory to standard therapies, according to a study presented at the Radiological Society of North America's 2017 annual meeting, held November 26 to December 1 in Chicago, Illinois.

For this single-center prospective study, the investigators administered pulsed radiofrequency (Cosman G4) for 10 minutes at 45 V using a 22‐20 gauge needle‐electrode with probe tip under CT guidance. The patients' quality of life was assessed with the Roland-Morris tool, and disability and pain were evaluated using the Oswestry Disability Index and the Visual Analogue Scale (VAS), respectively, at baseline and at 1-week, 1-month, and 3-month follow-up.

During the 3-year study period, a total of 80 patients received pulsed radiofrequency. The median VAS scores were reduced 1 week after treatment compared with baseline (3.5 vs 7.8, respectively). Similar reductions in VAS scores were observed at the 1-month (7.8 to 2.6) and 3-month (7.8 to 1.3) follow-up.

The Oswestry Disability Index scores indicated reduced disability following treatment at 1-week (12.5 points), 1-month (6.0 points), and 3-month (5.5 points) follow-up compared with baseline (78.0 points). Quality of life was improved by pulsed radiofrequency, as reflected by a decrease in Roland-Morris score from 16 points at baseline to 3 points at 1 month and 1.5 points at 3 months of treatment (P <.001). The majority of patients (90.0%) achieved a VAS score of 0 one month after receiving treatment, and 97.5% of participants reported a decrease of approximately 20 points on the Oswestry Disability Index at the 1-month follow-up.

“The results of this study are superior to those reported from literature for usual care strategies and injections and may avoid surgery for a substantial number of patients with sciatic disc compression,” concluded the researchers.

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Reference

Napoli A, Scipione R, Erasmus HP, et al. CT guided pulsed radiofrequency treatment of the lumbar dorsal root ganglion in patients with acute radicular low back pain. Presented at: RSNA 2017; November 26-December 1, 2017; Chicago, IL. Abstract SSK13-01.

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