title: Response to pulsed and continuous radiofrequency lesioning of the dorsal root ganglion and segmental nerves in patients with chronic lumbar radicular pain.
abstract: OBJECTIVE
  We aimed to prospectively evaluate the response and safety of pulsed and continuous radiofrequecy lesioning of the dorsal root ganglion/segmental nerves in patients with chronic lumbosacral radicular pain.
  
  
  METHODS
  Seventy-six patients with chronic lumbosacral radicular pain refractory to conventional therapy met the inclusion criteria and were randomly assigned to one of 2 types of treatment, pulsed radiofrequency lesioning of the dorsal root ganglion/segmental nerve or pulsed radiofrequency followed immediately by continuous radiofrequency. Patients were carefully evaluated for neurologic deficits and side effects. The response was evaluated at 2 months and was then tracked monthly. A Kaplan-Meier analysis was used to illustrate the probability of success over time and a Box-Whisker analysis was applied to determine the mean duration of a successful analgesic effect.
  
  
  RESULTS
  Two months after undergoing radiofrequency treatment, 70% of the patients treated with pulsed radiofrequency and 82% treated with pulsed and continuous radiofrequency had a successful reduction in pain intensity. The average duration of successful analgesic response was 3.18 months (+/- 2.81) in the group treated with pulsed radiofrequency and 4.39 months (+/-3.50) in those patients treated with pulsed and continuous radiofrequency lesioning. A Kaplan-Meier analysis illustrated that in both treatment groups the chance of success approached 50% in each group at 3 months. The vast majority of patients had lost any beneficial effects by 8 months. There was no statistical difference between the 2 treatment groups. No side effects or neurological deficits were found in either group.
  
  
  CONCLUSIONS
  Pulsed mode radiofrequency of the dorsal root ganglion of segmental nerves appears to be a safe treatment for chronic lumbosacral radicular pain. A significant number of patients can derive at least a short-term benefit. The addition of heat via continuous radiofrequency does not offer a significant advantage. A randomized controlled trial is now required to determine the effectiveness of pulsed radiofrequency.
authors: Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. tsimopou@bidmc.harvard.edu
authors: Thomas T
authors: TT
authors: Simopoulos
authors: Jan
authors: J
authors: Kraemer
authors: Jyotsna V
authors: JV
authors: Nagda
authors: Musa
authors: M
authors: Aner
authors: Zahid H
authors: ZH
authors: Bajwa
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004311:Double-Blind Method; D005069:Evaluation Studies as Topic; D005260:Female; D005727:Ganglia, Spinal / Q000528:radiation effects*; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010147:Pain Measurement; D010865:Pilot Projects; D011446:Prospective Studies; D011843:Radiculopathy / Q000000981:diagnostic imaging / Q000209:etiology*; D011846:Radio Waves / Q000009:adverse effects*; D011859:Radiography / Q000379:methods; D016896:Treatment Outcome