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.
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.