Pulsed Radiofrequency Treatment Adjacent to the Lumbar Dorsal Root Ganglion for the Management of Lumbosacral Radicular Syndrome: A Clinical Audit

• Published in: Pain medicine (Malden, Mass.) Mass.), 2011-09, Vol.12 (9), p.1322-1330
• Main Authors: Van Boxem, Koen, van Bilsen, Joselien, de Meij, Nelleke, Herrler, Andreas, Kessels, Fons, Van Zundert, Jan, van Kleef, Maarten
• Format: Article
• Language: English
• Subjects: Aged; Dorsal Root Ganglion; Drug therapy; Effect; Female; Ganglia, Spinal - physiopathology; Ganglia, Spinal - surgery; Humans; Lumbar Vertebrae - physiopathology; Lumbar Vertebrae - surgery; Lumbosacral Radicular Syndrome; Male; Medical Audit - methods; Medical research; Middle Aged; Pain management; Pulsed Radiofrequency; Pulsed Radiofrequency Treatment - methods; Radiculopathy - etiology; Radiculopathy - physiopathology; Radiculopathy - therapy; Spinal Nerve Roots - physiopathology; Spinal Nerve Roots - surgery; Spondylosis - complications; Spondylosis - physiopathology; Spondylosis - surgery; Syndrome; Treatment Outcome
• ISSN: 1526-2375; 1526-4637
• DOI: 10.1111/j.1526-4637.2011.01202.x

Introduction.  Lumbosacral radicular syndrome (LRS) is probably the most frequent neuropathic pain syndrome. Three months to 1 year after onset, 30% of the patients still experience ongoing pain. The management of those patients is complex, and treatment success rates are rather low. The beneficial effect of pulsed radiofrequency (PRF) therapy has been described for the treatment of LRS in case reports and in retrospective and prospective studies. Up until now, no neurological complications have been reported after PRF treatment. The current clinical audit has been performed to assess the amount of pain relief after a single PRF treatment. Methods.  Sixty consecutive patients who received a PRF treatment adjacent to the lumbar dorsal root ganglion for the management of LRS in the period 2007–2009 were included. The main study objective was to measure the reduction of pain after the pulsed radiofrequency treatment by using the global perceived effect. The primary end point was defined as at least 50% pain relief for a period of 2 months or longer. Results.  The primary end point was achieved in 29.5% of all the PRF interventions. After 6 months, 50% pain relief was still present in 22.9% of the cases and after 12 months in 13.1% of the cases. The need for pain medication was significantly lower after pulsed radiofrequency treatment in the success group compared with the nonsuccess group. Conclusions.  PRF treatment can be considered for the management of LRS patients. These results need to be confirmed in a randomized clinical trial.