title: Radiofrequency lesioning of dorsal root ganglia for chronic lumbosacral radicular pain: a randomised, double-blind, controlled trial.
abstract: BACKGROUND
  Results of observational studies have shown pain reduction with percutaneous radiofrequency lesioning of dorsal root ganglia for lumbosacral radicular pain, but there are few randomised controlled trials. We aimed to assess the efficacy of radiofrequency lesioning of dorsal root ganglia for lumbosacral radicular pain.
  
  
  METHODS
  We screened 1001 patients, who were mostly referred by their family doctor, in four hospitals for a double-blind randomised trial. 83 patients met inclusion criteria and thus were randomly assigned to receive a radiofrequency lesion or control treatment of the involved dorsal root ganglion. Control treatment was done in the same way as radiofrequency lesioning, but without radiofrequency current. Preoperatively and during 3-month follow-up, patients reported visual analogue leg-pain and back-pain scores, physical impairment, and use of analgesics in a diary. Primary outcome was success or failure of treatment, defined by a multidimensional decision rule, which included median outcome variables from the diary. Post-hoc analysis for possible covariate interference with outcome variables was done. Primary outcome data were analysed on an intention-to-treat basis.
  
  
  RESULTS
  45 patients were assigned radiofrequency lesioning and 38 control treatment. Three patients dropped out before 3 months. After 3 months, seven (16%) of 44 patients treated with radiofrequency lesioning and nine (25%) of 36 in the control group had successful treatment (difference -9.1% [95% CI -33.0 to 12.0], p=0.43). No differences between groups in side-effects were seen.
  
  
  CONCLUSIONS
  Lumbosacral radiofrequency lesioning of dorsal root ganglia failed to show advantage over control treatment with local anaesthetics. Thus, its use as routine treatment in lumbosacral radicular pain should not be advocated.
authors.affiliation: Division of Perioperative Medicine, Anaesthesiology, and Pain Management, University Medical Centre Utrecht, Utrecht, Netherlands. anesthesiologen.arnhem@planet.nl
authors.forename: Jos W M
authors.initials: JW
authors.lastname: Geurts
authors.forename: Roelof M A W
authors.initials: RM
authors.lastname: van Wijk
authors.forename: Herman J
authors.initials: HJ
authors.lastname: Wynne
authors.forename: Edwin
authors.initials: E
authors.lastname: Hammink
authors.forename: Erik
authors.initials: E
authors.lastname: Buskens
authors.forename: Richel
authors.initials: R
authors.lastname: Lousberg
authors.forename: Johannes T A
authors.initials: JT
authors.lastname: Knape
authors.forename: Gerbrand J
authors.initials: GJ
authors.lastname: Groen
mesh_terms: D017115:Catheter Ablation; D004311:Double-Blind Method; D005260:Female; D005727:Ganglia, Spinal / Q000601:surgery*; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010146:Pain / Q000209:etiology*; D059408:Pain Management; D010147:Pain Measurement; D011843:Radiculopathy / Q000601:surgery*; D016896:Treatment Outcome