title: Pulsed radiofrequency for chronic intractable lumbosacral radicular pain: a six-month cohort study.
abstract: OBJECTIVE
  There is little evidence concerning the medical management of lumbosacral radicular pain. The prognosis for patients suffering pain for more than 3 months is poor. Pulsed radiofrequency (PRF) treatment of the dorsal root ganglion (DRG) has been suggested as a minimally invasive treatment. We studied the effect on pain and quality of life of PRF treatment of the DRG in patients with chronic, severe lumbosacral radicular pain.
  
  
  METHODS
  Patients with lumbosacral radicular pain were screened to select a homogeneous population. PRF treatment of the DRG was performed at L5 or S1. Evaluation was carried out at 6 weeks, 3 months, and 6 months. Pain reduction and "fully recovered" or "much improvement," in terms of the global perceived effect, were the primary outcomes. Quality of life (RAND-36), disability (Oswestry Disability Index), and the neuropathic pain scales leeds assessment of neuropathic symptoms and signs (LANSS) and DN4 were registered at each time point. Medication use was scored with the Medication Quantification Scale.
  
  
  RESULTS
  Out of 461 screened patients, 65 were included. According to the intention to treat analysis, clinical success was achieved in 56.9%, 52.3%, and 55.4% of the patients at respectively 6 weeks, 3 months, and 6 months. DN4, Oswestry Disability Index and physical component for the RAND-36 quality of life improved significantly while the mental component remained unchanged. The number of patients on opioids was reduced.
  
  
  CONCLUSIONS
  PRF treatment of the DRG may be considered for patients with chronic, severe lumbosacral radicular pain refractory to conventional medical management.
authors.affiliation: Department of Anesthesiology & Pain Management, Maastricht University Medical Center MUMC, Maastricht, The Netherlands.|Department of Anesthesiology - Critical Care and Multidisciplinary Pain Center, Sint-Jozefkliniek Bornem & Willebroek, Bornem, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Van Boxem
authors.affiliation: Department of Anesthesiology & Pain Management, Maastricht University Medical Center MUMC, Maastricht, The Netherlands.
authors.forename: Nelleke
authors.initials: N
authors.lastname: de Meij
authors.affiliation: Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Maastricht, The Netherlands.
authors.forename: Alfons
authors.initials: A
authors.lastname: Kessels
authors.affiliation: Department of Anesthesiology & Pain Management, Maastricht University Medical Center MUMC, Maastricht, The Netherlands.|Department of Anesthesiology and Pain management, VUMC Amsterdam, Amsterdam, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: Van Kleef
authors.affiliation: Department of Anesthesiology, Critical Care and Multidisciplinary Pain Center, ZOL, Genk, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Van Zundert
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008161:Lumbosacral Region / Q000473:pathology; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D011446:Prospective Studies; D061208:Pulsed Radiofrequency Treatment / Q000379:methods*; D011843:Radiculopathy / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Conventional Medical Management; Dorsal Root Ganglion; Lumbosacral Radicular Pain; Pulsed Radiofrequency; Radiofrequency