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Electrocatheter-mediated High-voltage Pulsed Radiofrequency of the Dorsal Root Ganglion in the Treatment of Chronic Lumbosacral Neuropathic Pain: A Randomized Controlled Study

Despite the interest in scientific community, there is still poor evidence about pulsed radiofrequency (PRF) efficacy in the treatment of neuropathic pain. In order to determine whether high-voltage PRF and epidural adhesiolysis (PRF-EA) showed better results than epidural adhesiolysis alone (EA), a...

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Autores principales: Vigneri, Simone, Sindaco, Gianfranco, La Grua, Marco, Zanella, Matteo, Lo Bianco, Giuliano, Paci, Valentina, Vinci, Francesca M., Sciacca, Chiara, Ravaioli, Laura, Pari, Gilberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6903354/
https://www.ncbi.nlm.nih.gov/pubmed/31577546
http://dx.doi.org/10.1097/AJP.0000000000000766
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author Vigneri, Simone
Sindaco, Gianfranco
La Grua, Marco
Zanella, Matteo
Lo Bianco, Giuliano
Paci, Valentina
Vinci, Francesca M.
Sciacca, Chiara
Ravaioli, Laura
Pari, Gilberto
author_facet Vigneri, Simone
Sindaco, Gianfranco
La Grua, Marco
Zanella, Matteo
Lo Bianco, Giuliano
Paci, Valentina
Vinci, Francesca M.
Sciacca, Chiara
Ravaioli, Laura
Pari, Gilberto
author_sort Vigneri, Simone
collection PubMed
description Despite the interest in scientific community, there is still poor evidence about pulsed radiofrequency (PRF) efficacy in the treatment of neuropathic pain. In order to determine whether high-voltage PRF and epidural adhesiolysis (PRF-EA) showed better results than epidural adhesiolysis alone (EA), a randomized, double-blind, comparative-effectiveness study was conducted in patients with chronic lumbosacral radiating pain and neuropathic features. MATERIALS AND METHODS: A total of 41 patients were randomly allocated to 2 groups. Twenty-one patients were randomized to receive 2 cycles of 240 seconds high-voltage PRF followed by the injection of local anesthetics, hyaluronidase, and betamethasone, whereas 20 patients underwent sham stimulation followed by adhesiolysis. The treatment was delivered at the affected lumbosacral roots and patients, treating physicians and assessors were blinded to intervention. RESULTS: A significant reduction of radiating pain was observed in mean Numeric Rating Scale score at follow-up. A change of −3.43 versus −1.75 (P=0.031) after 1 month and −3.34 versus −0.80 (P=0.005) after 6 months was reported in patients undergoing PRF-EA in comparison with EA, respectively. After 1 month, 57% of patients in the PRF-EA group experienced a pain reduction of ≥50% versus only 25% of patients allocated to EA (P=0.037). Improvement decreased to 48% in the PRF-EA group whereas only 10% of EA reported significant pain relief after 6 months (P=0.008). DISCUSSION: High-voltage PRF of dorsal root ganglion delivered through multifunctional electrode provided significant pain relief and may be considered a valuable treatment in chronic lumbosacral radicular pain with neuropathic features.
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spelling pubmed-69033542020-01-22 Electrocatheter-mediated High-voltage Pulsed Radiofrequency of the Dorsal Root Ganglion in the Treatment of Chronic Lumbosacral Neuropathic Pain: A Randomized Controlled Study Vigneri, Simone Sindaco, Gianfranco La Grua, Marco Zanella, Matteo Lo Bianco, Giuliano Paci, Valentina Vinci, Francesca M. Sciacca, Chiara Ravaioli, Laura Pari, Gilberto Clin J Pain Original Articles Despite the interest in scientific community, there is still poor evidence about pulsed radiofrequency (PRF) efficacy in the treatment of neuropathic pain. In order to determine whether high-voltage PRF and epidural adhesiolysis (PRF-EA) showed better results than epidural adhesiolysis alone (EA), a randomized, double-blind, comparative-effectiveness study was conducted in patients with chronic lumbosacral radiating pain and neuropathic features. MATERIALS AND METHODS: A total of 41 patients were randomly allocated to 2 groups. Twenty-one patients were randomized to receive 2 cycles of 240 seconds high-voltage PRF followed by the injection of local anesthetics, hyaluronidase, and betamethasone, whereas 20 patients underwent sham stimulation followed by adhesiolysis. The treatment was delivered at the affected lumbosacral roots and patients, treating physicians and assessors were blinded to intervention. RESULTS: A significant reduction of radiating pain was observed in mean Numeric Rating Scale score at follow-up. A change of −3.43 versus −1.75 (P=0.031) after 1 month and −3.34 versus −0.80 (P=0.005) after 6 months was reported in patients undergoing PRF-EA in comparison with EA, respectively. After 1 month, 57% of patients in the PRF-EA group experienced a pain reduction of ≥50% versus only 25% of patients allocated to EA (P=0.037). Improvement decreased to 48% in the PRF-EA group whereas only 10% of EA reported significant pain relief after 6 months (P=0.008). DISCUSSION: High-voltage PRF of dorsal root ganglion delivered through multifunctional electrode provided significant pain relief and may be considered a valuable treatment in chronic lumbosacral radicular pain with neuropathic features. Lippincott Williams & Wilkins 2020-01 2019-10-01 /pmc/articles/PMC6903354/ /pubmed/31577546 http://dx.doi.org/10.1097/AJP.0000000000000766 Text en Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Original Articles
Vigneri, Simone
Sindaco, Gianfranco
La Grua, Marco
Zanella, Matteo
Lo Bianco, Giuliano
Paci, Valentina
Vinci, Francesca M.
Sciacca, Chiara
Ravaioli, Laura
Pari, Gilberto
Electrocatheter-mediated High-voltage Pulsed Radiofrequency of the Dorsal Root Ganglion in the Treatment of Chronic Lumbosacral Neuropathic Pain: A Randomized Controlled Study
title Electrocatheter-mediated High-voltage Pulsed Radiofrequency of the Dorsal Root Ganglion in the Treatment of Chronic Lumbosacral Neuropathic Pain: A Randomized Controlled Study
title_full Electrocatheter-mediated High-voltage Pulsed Radiofrequency of the Dorsal Root Ganglion in the Treatment of Chronic Lumbosacral Neuropathic Pain: A Randomized Controlled Study
title_fullStr Electrocatheter-mediated High-voltage Pulsed Radiofrequency of the Dorsal Root Ganglion in the Treatment of Chronic Lumbosacral Neuropathic Pain: A Randomized Controlled Study
title_full_unstemmed Electrocatheter-mediated High-voltage Pulsed Radiofrequency of the Dorsal Root Ganglion in the Treatment of Chronic Lumbosacral Neuropathic Pain: A Randomized Controlled Study
title_short Electrocatheter-mediated High-voltage Pulsed Radiofrequency of the Dorsal Root Ganglion in the Treatment of Chronic Lumbosacral Neuropathic Pain: A Randomized Controlled Study
title_sort electrocatheter-mediated high-voltage pulsed radiofrequency of the dorsal root ganglion in the treatment of chronic lumbosacral neuropathic pain: a randomized controlled study
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6903354/
https://www.ncbi.nlm.nih.gov/pubmed/31577546
http://dx.doi.org/10.1097/AJP.0000000000000766
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