Abstract
Discogenic pain is an important cause of low back pain (LBP). We have developed a pulsed radiofrequency (P-RF) technique, using two electrodes placed bilaterally in the annulus, for applying radiofrequency current in the disc (bi-annular P-RF disc method). The purpose of this study was to investigate the effect of the bi-annular P-RF disc method, using Diskit needles (Neurotherm, Middleton, MA, USA) in patients with discogenic LBP. The subjects were 15 patients with a mean age of 37.3 ± 8.63 years with chronic discogenic lower back pain that was not responsive to aggressive nonoperative care. Two Diskit II needles (15-cm length, 20G needles with a 20-mm active tip) were placed bilaterally in the annulus in the disc. Pulsed radiofrequency was applied for 12 min at a setting of 5 × 50 ms/s and 60 V. The pain intensity scores on a 0–10 numeric rating scale (NRS) and the Roland–Morris Disability Questionnaire (RMDQ) were measured pretreatment, and at 1 week and 1, 3, and 6 months post-treatment. The mean pain severity score (NRS) improved from 7.27 ± 0.58 pretreatment to 2.5 ± 0.94 at the 6-month follow-up (p < 0.01). The RMDQ showed significant (p < 0.01) improvement, from 10.70 ± 2.35 pretreatment to 2.10 ± 1.85 at the 6-month follow up (p < 0.01). The bi-annular P-RF disc method with consecutive P-RF 5/5/60 V, 12-min (with Diskit needle), appears to be a safe, minimally invasive treatment option for patients with chronic discogenic LBP.
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References
Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N. The prevalence and clinical features of internal disc disruption in patients with chronic low back pain. Spine. 1995;20:1878–83.
Zhou Y, Abdi S. Diagnosis and minimally invasive treatment of lumbar discogenic pain—a review of the literature. Clin J Pain. 2006;22:468–81.
Freemont AJ, Peacock TE, Goupille P, Hoyland JA, O’Brien J, Jayson MI. Nerve ingrowth into diseased intervertebral disc in chronic back pain. Lancet. 1997;350:178–81.
Appleby D, Anderson G, Totta M. Meta-analysis of the efficacy and safety of intradiscal electrothermal therapy (IDET). Pain Med. 2006;7:308–16.
Freeman BJ. IDET: a critical appraisal of the evidence. Eur Spine J. 2006;15(Suppl 3):S448–57.
Rathmell J, Saal JS, Saal J. Discography, IDET, percutaneous discectomy, and nucleoplasty: complications and their prevention. Pain Med. 2008;9:S73–81.
Cosman EJ, Cosman ES. Electric and thermal field effects in tissue around radiofrequency electrodes. Pain Med. 2005;6:405–24.
Bogduk N. Pulsed radiofrequency. Pain Med. 2006;7:396–407.
Teixeira A, Sluijter ME. Intradiscal high-voltage, long-duration pulsed radiofrequency for discogenic pain: a preliminary report. Pain Med. 2006;7:424–8.
Ohtori S, Kinoshita T, Yamashita M, Yamauchi K, Koshi T, Suzuki M, Orita S, Eguchi Y, Nakamura S, Yamagata M, Takaso M, Ochiai N, Kishida S, Aoki Y, Takahashi K. Results of surgery for discogenic low back pain: a randomized study using discography versus discoblock for diagnosis. Spine. 2009;34:1345–8.
Fujiwara A, Kobayashi N, Saiki K, Kitagawa T, Tamai K, Saotome K. Association of the Japanese Orthopaedic Association Score with the Oswestry Disability Index, Roland–Morris Disability Questionnaire, and short-form 36. Spine. 2003;28:1601–7.
Sluijter ME, Teixeira A, Serra V, Balogh S, Schianchi P. Intra-articular application of pulsed radiofrequency for arthrogenic pain—report of six cases. Pain Pract. 2008;8:57–61.
Nicholas HL, Vissers KC, Sluijter ME. Pulsed radiofrequency treatment in interventional pain management: mechanisms and potential. indications—a review. Acta Neurochir. 2011;153:763–71.
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Fukui, S., Rohof, O. Results of pulsed radiofrequency technique with two laterally placed electrodes in the annulus in patients with chronic lumbar discogenic pain. J Anesth 26, 606–609 (2012). https://doi.org/10.1007/s00540-012-1385-7
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DOI: https://doi.org/10.1007/s00540-012-1385-7