title: Retrospective review of the efficacy and safety of repeated pulsed and continuous radiofrequency lesioning of the dorsal root ganglion/segmental nerve for lumbar radicular pain.
abstract: BACKGROUND
  Chronic lumbosacral radicular pain is a common source of radiating leg pain seen in pain management patients. These patients are frequently managed conservatively with multiple modalities including medications, physical therapy, and epidural steroid injections. Radiofrequency has been used to treat chronic radicular pain for over 30 years; however, there is a paucity of literature about the safety and efficacy of repeat radiofrequency lesioning.
  
  
  OBJECTIVE
  To determine the safety, success rate, and duration of pain relief of repeat pulsed radiofrequency (PRF) and continuous radiofrequency (CRF) lesioning of the dorsal root ganglion (DRG)/ sacral segmental nerves (SN) in patients with chronic lumbosacral radicular pain.
  
  
  METHODS
  Retrospective chart review
  
  
  METHODS
  Outpatient multidisciplinary pain center
  
  
  METHODS
  Medical record review of patients who were treated with pulsed and continuous radiofrequency lesioning of the lumbar dorsal root ganglia and segmental nerves and who reported initial success were evaluated for recurrence of pain and repeat radiofrequency treatment. Responses to subsequent treatments were compared to initial treatments for success rates, average duration of relief, and adverse neurologic side-effects.
  
  
  CONCLUSIONS
  Retrospective chart review without a control group.
  
  
  RESULTS
  Twenty-six women and 24 men were identified who received 50% pain relief or better after PRF and CRF of the lumbar DRG/ sacral SN for lumbosacral radicular pain. The mean age was 62 years (range, 25-86). The mean duration of relief for the 40 patients who had 2 treatments was 4.7 months (range 0-24; Se [standard error] 0.74). Twenty-eight patients had 3 treatments with an average duration of relief of 4.5 months (range 0-19 months; Se 0.74). Twenty patients had 4 treatments with a mean duration of relief of 4.4 months (range 0.5-18; Se 0.95) and 18 patients who had 5 or more treatments received an average duration of relief of 4.3 months (range 0.5-18; Se 1.03). The average duration of relief and success frequency remained constant after each subsequent radiofrequency treatment. Of the 50 total patients, there was only 1 reported complication, specifically, transient thigh numbness which resolved after one week.
  
  
  CONCLUSIONS
  Repeated pulsed and continuous radiofrequency ablation of the lumbar dorsal root ganglion/segmental nerve shows promise to be a safe and effective long-term palliative management for lumbosacral radicular pain in some patients.
authors.affiliation: Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA. jnagda@bidmc.harvard.edu
authors.forename: Jyotsna V
authors.initials: JV
authors.lastname: Nagda
authors.forename: Craig W
authors.initials: CW
authors.lastname: Davis
authors.forename: Zahid H
authors.initials: ZH
authors.lastname: Bajwa
authors.forename: Thomas T
authors.initials: TT
authors.lastname: Simopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005727:Ganglia, Spinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology / Q000601:surgery*; D011843:Radiculopathy / Q000150:complications / Q000601:surgery*; D000078702:Radiofrequency Therapy; D012189:Retrospective Studies