A novel radiofrequency thermocoagulation method for treatment of lower back pain: thermal conduction after instillation of saline solution into the nucleus pulposus--preliminary results.
BACKGROUND
Radiofrequency heating of the intervertebral disc has been proposed for the treatment of chronic low back pain using two methods: a flexible needle inserted into the annulus fibrosus achieving a full 360 degrees penetration, or a rigid needle inserted into the nucleus pulposus. The first technique is effective on pain, but the clinical benefit of the second is uncertain.


OBJECTIVE
To evaluate a technique for radiofrequency heating of the lumbar intervertebral disc by a needle placed into the nucleus pulposus.


METHODS
The method was tested in 17 patients according to the criteria used in previous intradiscal radiofrequency studies. Before and after treatment, disability was assessed by the Oswestry disability score. A pain reduction of at least 50% was considered a success.


RESULTS
Fifteen patients were responders at 1 month (88%), nine at 3 months (53%), and 12 at 6 months (70.6%). No complications were observed.


CONCLUSIONS
A new method of providing discal radiofrequency treatment for lower back pain had a substantial clinical benefit in 71% of the observed patients. A prospective study comparing this new method with placebo should be conducted to confirm these initial results.
Azulay
N
N
Department of Radiology, Saint Joseph Hospital, Paris, France.
Forgerit
M
M
Alava
E G
EG
Deplas
A
A
Vialle
R
R
Ragot
S
S
Tasu
J-P
JP
D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D017116:Low Back Pain / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010147:Pain Measurement / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage*; D013814:Thermal Conductivity
D012965:Sodium Chloride