Comparison between bipolar pulsed radiofrequency and monopolar pulsed radiofrequency in chronic lumbosacral radicular pain

Lee, Hee Jin; Cho, Yun Woo; Ahn, Sang Ho

doi:10.1097/md.0000000000006236

Cited by 34 publications

(35 citation statements)

References 30 publications

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“…Although it is known that CRF treatment may damage neural structures, Slappendel et al compared the pain reducing effects of CRF treatment applied at 40 0 C and 67 0 C in patients with cervicobrachialgia, and they reported similar findings using the two temperatures, without complications 21 . In clinical practice, it may be said that PRF treatment is the preferred method due to the lesser potential of neural tissue damage than CRF treatment 2,5,9 . However, in the present study, we did not find any complications, including sensorial and motor deficits, in the PRF and CRF groups.…”

Section: Discussionmentioning

confidence: 99%

Pulsed and conventional radiofrequency thermocoagulation applications on low back pain

Hatipoğlu¹,

Özbek²

2019

Cukurova Medical Journal

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Nowadays, low back pain (LBP) is an important health problem. Radiofrequency (RF) treatments can generate different temperature levels by transferring energy to the targeted tissue, and which is an effective interventional treatment method for LBP patients. In this study, we compared the effects of pulsed and conventional RF treatments on patients with LBP. Materials and Methods: Thirty patients with LBP histories for longer than three months received pulsed (42 0C, 240 s) (n=15) and conventional (65 0C, 120 s) (n=15) RF treatments. The baseline and one and three months after the procedure, the patients' pain and disability values were obtained using a Visual Analogue Scale (VAS) and the modified Oswestry Disability Index (ODI), respectively. The results of the patients' neurological examinations were also recorded. Results: The VAS and modified ODI values were reduced in both groups one and three months after the RF treatments when compared to the baseline values However, no statistically significant differences were found between the two groups. In addition, there were no statistically significant differences between the two groups in terms of the neurological examination results involving motor, sensorial, and reflex losses. Conclusion: The pulsed and conventional RF treatments exhibited similar effects in the LBP patients. Therefore, higher temperatures do not provide an advantage. Pulsed RF treatment applied to the dorsal root ganglion is a safe and effective way to avoid possible side effects.

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Section: Discussionmentioning

confidence: 99%

Pulsed and conventional radiofrequency thermocoagulation applications on low back pain

Hatipoğlu¹,

Özbek²

2019

Cukurova Medical Journal

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“…However, despite these treatments, pain persists in some patients. The recently introduced pulsed radiofrequency (PRF) technique is widely used to provide relief from chronic pain (8)(9)(10)(11)(12)(13)(14)(15). Although the mechanism of its pain-relieving effect has not been clearly elucidated, the electrical field generated by PRF has been suggested to be responsible for its clinical effect.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…Because of this minimal tissue-destructive character, PRF has been rapidly adopted in clinical practice to treat different types of pain, including neuralgia, joint pain, and muscle pain. When PRF stimulation was first introduced, it was usually applied to nerve tissues like dorsal root ganglia and medial branch nerves of the spine (8,9,11,13,14). However, novel stimulation methods have been recently devised, such as intraarticular and interfascial stimulation (10,12).…”

Section: Outcome Measuresmentioning

confidence: 99%

The Effect of Caudal Epidural Pulsed Radiofrequency Stimulation in Patients with Refractory Chronic Idiopathic Axonal Polyneuropathy

Lee

Chang

2018

Pain Phys

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Background: Many patients with chronic idiopathic axonal polyneuropathy (CIAP) suffer from neuropathic pain, which is managed using several oral medications and modalities. However, despite these treatments, pain persists in some patients. Objective: In the clinical field, clinicians frequently meet patients with neuropathic pain caused by CIAP. The authors investigated the effect of caudal epidural pulsed radiofrequency (PRF) for the management of CIAP-induced refractory neuropathic pain. Study Design: This is a prospective study. Setting: The outpatient clinic of a single academic medical center in Korea Methods: Twenty patients with neuropathic pain and a diagnosis of refractory CIAP were recruited. For PRF stimulation, a 22-gauge cannula was inserted into the epidural space through the sacral hiatus under fluoroscopic guidance. PRF stimulation was administered once at 5 Hz with a 5-ms pulse width for 600 seconds at 55 V. The effect of stimulation was evaluated using a numeric rating scale (NRS) at 2 weeks and 1, 2, and 3 months after the procedure. Successful pain relief was defined as a reduction in the NRS score of ≥ 50% as compared with the score prior to treatment. In addition, at 3 months after treatment, patient satisfaction levels were examined; patients that reported “very good” (score = 7) or “good” (score = 6) results were considered to be satisfied with the procedure. Results: Neuropathic pain was significantly reduced at 2 weeks and at 1, 2, and 3 months followup after PRF (P < 0.001, repeated measures one-factor analysis). In addition, at 3 months post-PRF, half of the patients achieved a successful response (≥ 50% pain reduction) and were satisfied with treatment results. Limitations: A small number of patients were recruited, and we did not perform long-term follow-up. Conclusion: Caudal epidural PRF may be a good treatment option for managing neuropathic pain induced by CIAP, especially when pain is unresponsive to oral medications. Key words: Pulsed radiofrequency, chronic idiopathic axonal neuropathy, caudal epidural stimulation, neuropathic pain chronic pain, refractory pain

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“…The prevalence of backache among the elderly is reported to be 84% (Balague et al, 2012). Radicular pains are usually the result of nerve root infl ammation or, sometimes, take place without mechanical stimulation (Chang et al, 2017). One of the major complications caused by intervertebral disc herniation is the epidural space and nerve roots infl ammation.…”

Section: Introductionmentioning

confidence: 99%

“…One of the major complications caused by intervertebral disc herniation is the epidural space and nerve roots infl ammation. As clinical studies indicate, radicular pain caused by nerve root infl ammation in epidural space is the result of disk leakage, pressure on nerve root arteries or stimulation of dorsal root ganglia due to spinal stenosis (Chang et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Comparative studies on the success level of sonographic guided epidural steroid injection and its effectiveness with fluoroscopy techniques in treating lumbar radicular pain

Gelinimoghaddam¹,

Hashemi²,

Dadkhah³

et al. 2017

Biosci. Biotech. Res. Comm

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Limitations of using fl uoroscopic guidance in epidural steroid injection have encouraged the researchers to look for an appropriate alternative method. Compared to fl uoroscopy, sonography has exceptional properties that have made it a useful method. The present research seeks to study the success of sonographic guided epidural steroid injection and compare its effectiveness with fl uoroscopy in treating lumbar radicular pain.This is a single-blind, randomized research conducted on 50 patients complaining about lumbar radicular pain. The participants were then randomly divided into two therapeutic groups consisting of 25 people: sonographic guided and fl uoroscopy guided groups. The initial examination recorded the demographic information of each patient in his profi le. The pain scale and performance disability and therapeutic satisfaction of each patient were measured 48 hours and 2 weeks after intervention and analyzed using statistical tests. The patients studied aged from 23 to 70 years (with an average of 45.74 ± 16.02 years) and were divided equally between the two groups in terms of gender. There was no statistically signifi cant difference between the two groups in terms of contrast matter distribution, but the average injection procedure in sonography group (101.22 ± 36.48 s) was signifi cantly faster than what was observed in fl uoroscopy group (311.46 ± 52.13 s) (P-value < 0.05). There was no statistically signifi cant difference between the two groups in terms of pain variable, performance disability and patients' satisfaction (P-value > 0.05). There was no statistically signifi cant correlation between gender and BMI with pain and performance disability in any one of these groups.The results have shown that sonographic and fl uoroscopic tools have equal capabilities in epidural steroid injection. The superiority of sonography to fl uoroscopy have made it possible to use this technique for epidural steroid injection.

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Comparison between bipolar pulsed radiofrequency and monopolar pulsed radiofrequency in chronic lumbosacral radicular pain

Cited by 34 publications

References 30 publications

Pulsed and conventional radiofrequency thermocoagulation applications on low back pain

Pulsed and conventional radiofrequency thermocoagulation applications on low back pain

The Effect of Caudal Epidural Pulsed Radiofrequency Stimulation in Patients with Refractory Chronic Idiopathic Axonal Polyneuropathy

Comparative studies on the success level of sonographic guided epidural steroid injection and its effectiveness with fluoroscopy techniques in treating lumbar radicular pain

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