Percutaneous pulsed radiofrequency applied to the L-2 dorsal root ganglion for treatment of chronic low-back pain: 3-year experience.
OBJECTIVE
The authors assessed the effectiveness of percutaneous pulsed radiofrequency treatment for providing pain relief in patients with chronic low-back pain with or without lower-limb pain.


METHODS
Data were obtained in 127 patients who had chronic low-back pain with or without lower-limb pain due to a herniated intervertebral disc or previous failed back surgery and who underwent pulsed radiofrequency treatment. Their conditions were proven by clinical features, physical examination, and imaging studies. Low-back pain was treated with pulsed radiofrequency applied to the L-2 dorsal root ganglion (DRG) and lower-limb pain was treated with pulsed radiofrequency applied to the L3-S1 DRG. Patients underwent uni- or bilateral treatment depending on whether their low-back pain was unilateral or bilateral. A visual analog scale was used to assess pain. The patients were followed up for 3 years postoperatively.


RESULTS
In patients without lower-limb pain (Group A), 27 (55.10%) of 49 patients had initial improvement >or= 50% at 3-month follow-up. At 1-year follow-up, 20 (44.44%) of 45 patients in Group A had pain relief >or= 50%. An analysis of patients with pain relief >or= 50% for at least 1 month showed that the greatest effect was at 3 months after treatment. In patients with low-back pain and lower-limb pain (Group B), 37 (47.44%) of 78 patients had initial improvement >or= 50% at 3-month follow-up. At 1-year follow-up, 34 (45.95%) of 74 patients had pain relief effect >or= 50%. An analysis of patients in Group B with pain relief >or= 50% for at least 1 month showed that the greatest effect was at 1 month after treatment.


CONCLUSIONS
The results of this prospective analysis showed that treatment with pulsed radiofrequency applied at the L-2 DRG is safe and effective for treating for chronic low-back pain. Satisfactory pain relief was obtained in the majority of patients in Group A with the effect persisting for at least 3 months. The results indicate that pulsed radiofrequency provided intermediate-term relief of low-back pain. Further studies with long-term follow-up are necessary.
Tsou
Hsi-Kai
HK
Department of Neurosurgery, Taichung Veterans General Hospital, Feng Chia University, Taichung, Taiwan, Republic of China. tsouhsikai@gmail.com
Chao
Shao-Ching
SC
Wang
Chao-Jan
CJ
Chen
Hsien-Te
HT
Shen
Chiung-Chyi
CC
Lee
Hsu-Tung
HT
Tsuei
Yuang-Seng
YS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D005727:Ganglia, Spinal / Q000503:physiopathology*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications; D007866:Leg; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D059408:Pain Management; D011446:Prospective Studies; D000078702:Radiofrequency Therapy; D012447:Sacrum / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome