Results of intradiscal pulsed radiofrequency for lumbar discogenic pain: comparison with intradiscal electrothermal therapy

Sei Fukui, Kazuhito Nitta, Narihito Iwashita, Hisashi Tomie, Shuichi Nosaka, Olav Rohof, Sei Fukui, Kazuhito Nitta, Narihito Iwashita, Hisashi Tomie, Shuichi Nosaka, Olav Rohof

Abstract

Background: We have developed an intradiscal pulsed radiofrequency (Disc PRF) technique, using Diskit II® needles (NeuroTherm, Wilmington, MA, USA), as a minimally invasive treatment option for chronic discogenic low back pain (LBP). The purpose of this study was to compare the representative outcomes of Disc PRF and Intradiscal Electrothermal Therapy (IDET) in terms of pain relief and reduction of disability.

Methods: Thirty-one patients with chronic discogenic LBP who underwent either Disc PRF (n = 15) or IDET (n = 16) were enrolled in the study. A Diskit II® needle (15-cm length, 20-gauge needle with a 20-mm active tip) was placed centrally in the disc. PRF was applied for 15 min at a setting of 5 × 50 ms/s and 60 V. The pain intensity score on a 0-10 numeric rating scale (NRS) and the Roland-Morris Disability Questionnaire (RMDQ) were assessed pretreatment and at 1, 3, and 6 months post-treatment.

Results: The mean NRS was significantly improved from 7.2 ± 0.6 pretreatment to 2.5 ± 0.9 in the Disc PRF group, and from 7.5 ± 1.0 to 1.7 ± 1.5 in the IDET group, at the 6-month follow-up. The mean RMDQ also showed significant improvement in both the Disc PRF group and the IDET group at the 6-month follow-up. There were no significant differences in the pretreatment NRS and RMDQ scores between the groups.

Conclusions: Disc PRF appears to be an alternative to IDET as a safe, minimally invasive treatment option for patients with chronic discogenic LBP.

Keywords: Intradiscal Electrothermal Therapy; intervertebral disc degeneration; low back pain; pulsed radiofrequency treatment.

Figures

Fig. 1
Fig. 1
Intradiscal pulsed radiofrequency (Disc PRF) procedures. Lateral view and anteroposterior (AP) view show that the Diskit II® needle is positioned in the L4/5 and the active part of the needle is completely inside the disc.
Fig. 2
Fig. 2
Numeric Rating Scale (NRS) scores pre-procedure and at 1, 3, and 6 months post-treatment in the Disc PRF and IDET groups. Data are presented as median and lower limit, 25th, 75th, and upper limit percentiles. Wilcoxon signed-rank test and Mann-Whitney U test. *P < 0.01. NS: not significant.
Fig. 3
Fig. 3
Roland-Morris Disability Questionnaire (RMDQ) scores pre-procedure and at 1, 3, and 6 months post-treatment in the Disc PRF and IDET groups. Data are presented as median and lower limit, 25th, 75th, and upper limit percentiles. Wilcoxon signed-rank test and Mann-Whitney U test. *P < 0.01. NS: not significant.

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Source: PubMed

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