Previous Lumbar Spine Surgery Decreases the Therapeutic Efficacy of Dorsal Root Ganglion Pulsed Radiofrequency in Patients with Chronic Lumbosacral Radicular Pain

Overview

Journal J Pers Med

Date 2023 Jul 29

PMID 37511667

Authors

Jiri Jandura

Milan Vajda

Roman Kostysyn

Jiri Vanasek

Eva cermakova

Jan Zizka

Pavel Ryska

Affiliations

Soon will be listed here.

Abstract

Chronic lumbosacral radicular pain (CLRP) as a possible adverse consequence of lumbar spine surgery represents a serious medical challenge. Pulsed radiofrequency of dorsal root ganglion (PRF-DRG) treatment is known to be effective in alleviating CLRP. This retrospective study compares the efficacy of a single CT-guided PRF-DRG procedure in the treatment of unilateral CLRP between patients without (non-PSS) and with (PSS) previous lumbar spine surgery. Non-PSS and PSS groups included 30 and 20 patients, respectively. Outcomes (pain intensity and disability) were evaluated by means of the visual analog scale (VAS) and Oswestry disability index (ODI) immediately after the procedure (VAS), as well as three and six months after the procedure, respectively. Non-PSS group showed a significant ( ˂ 0.001) decrease of VAS (median) at all follow-up intervals (from 6 to 4; 4; 4.5 points, respectively). The PSS group showed a significant yet transient VAS (median) decrease (from 6 to 5 points) immediately after the procedure only ( < 0.001). The decrease of VAS was more pronounced in the non-PSS group after three and six months ( = 0.0054 and 0.011, respectively) in intergroup comparison. A relative decrease of VAS ≥ 50% during follow-up was achieved in 40%; 43.3%; 26.7% (non-PSS), and 25%; 5%; 0% (PSS) of patients. ODI (median) significantly decreased in the non-PSS group (from 21.5 to 18 points) at three and six months ( = 0.014 and 0.021, respectively). In conclusion, previous lumbar spine surgery decreases the therapeutic efficacy of PRF-DRG procedure in CLRP patients.

Citing Articles

Transforaminal Steroid Injection After Dorsal Root Ganglion Pulsed Radiofrequency (DRG-PRF): Impact on Pain Intensity and Disability.

Leoni M, Micheli F, Abbott D, Cascella M, Varrassi G, Sansone P Pain Ther. 2024; 13(5):1271-1285.

PMID: 39068636 PMC: 11393363. DOI: 10.1007/s40122-024-00639-w.

References

Lee C, Chen C, Chou C, Wang H, Chung W, Peng G . Lumbar Dorsal Root Ganglion Block as a Prognostic Tool Before Pulsed Radiofrequency: A Randomized, Prospective, and Comparative Study on Cost-Effectiveness. World Neurosurg. 2018; 112:e157-e164. DOI: 10.1016/j.wneu.2017.12.183. View

Daniell J, Osti O . Failed Back Surgery Syndrome: A Review Article. Asian Spine J. 2018; 12(2):372-379. PMC: 5913031. DOI: 10.4184/asj.2018.12.2.372. View

Vigneri S, Sindaco G, Gallo G, Zanella M, Paci V, La Grua M . Effectiveness of pulsed radiofrequency with multifunctional epidural electrode in chronic lumbosacral radicular pain with neuropathic features. Pain Physician. 2014; 17(6):477-86. View

Ortiz A, De Moura A, Johnson B . Postsurgical Spine: Techniques, Expected Imaging Findings, and Complications. Semin Ultrasound CT MR. 2018; 39(6):630-650. DOI: 10.1053/j.sult.2018.10.017. View

Chang M . Efficacy of Pulsed Radiofrequency Stimulation in Patients with Peripheral Neuropathic Pain: A Narrative Review. Pain Physician. 2018; 21(3):E225-E234. View

Shanthanna H, Chan P, McChesney J, Thabane L, Paul J . Pulsed radiofrequency treatment of the lumbar dorsal root ganglion in patients with chronic lumbar radicular pain: a randomized, placebo-controlled pilot study. J Pain Res. 2014; 7:47-55. PMC: 3894138. DOI: 10.2147/JPR.S55749. View

Hussain A, Erdek M . Interventional pain management for failed back surgery syndrome. Pain Pract. 2013; 14(1):64-78. DOI: 10.1111/papr.12035. View

Facchini G, Spinnato P, Guglielmi G, Albisinni U, Bazzocchi A . A comprehensive review of pulsed radiofrequency in the treatment of pain associated with different spinal conditions. Br J Radiol. 2017; 90(1073):20150406. PMC: 5605093. DOI: 10.1259/bjr.20150406. View

Sluijter M, Racz G . Technical aspects of radiofrequency. Pain Pract. 2006; 2(3):195-200. DOI: 10.1046/j.1533-2500.2002.02023.x. View

10.

Radhakrishnan K, Litchy W, OFallon W, Kurland L . Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990. Brain. 1994; 117 ( Pt 2):325-35. DOI: 10.1093/brain/117.2.325. View

11.

Kim S, Park S, Yoon D, Yoon K, Kim S . Predictors of the analgesic efficacy of pulsed radiofrequency treatment in patients with chronic lumbosacral radicular pain: a retrospective observational study. J Pain Res. 2018; 11:1223-1230. PMC: 6027680. DOI: 10.2147/JPR.S164414. View

12.

SLUIJTER M . The role of radiofrequency in failed back surgery patients. Curr Rev Pain. 2000; 4(1):49-53. DOI: 10.1007/s11916-000-0009-3. View

13.

Shiri R, Lallukka T, Karppinen J, Viikari-Juntura E . Obesity as a risk factor for sciatica: a meta-analysis. Am J Epidemiol. 2014; 179(8):929-37. DOI: 10.1093/aje/kwu007. View

14.

Chan C, Peng P . Failed back surgery syndrome. Pain Med. 2011; 12(4):577-606. DOI: 10.1111/j.1526-4637.2011.01089.x. View

15.

Mehta V, Snidvongs S, Ghai B, Langford R, Wodehouse T . Characterization of peripheral and central sensitization after dorsal root ganglion intervention in patients with unilateral lumbosacral radicular pain: a prospective pilot study. Br J Anaesth. 2017; 118(6):924-931. DOI: 10.1093/bja/aex089. View

16.

Dworkin R, OConnor A, Backonja M, Farrar J, Finnerup N, Jensen T . Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain. 2007; 132(3):237-251. DOI: 10.1016/j.pain.2007.08.033. View

17.

Fari G, de Sire A, Fallea C, Albano M, Grossi G, Bettoni E . Efficacy of Radiofrequency as Therapy and Diagnostic Support in the Management of Musculoskeletal Pain: A Systematic Review and Meta-Analysis. Diagnostics (Basel). 2022; 12(3). PMC: 8947614. DOI: 10.3390/diagnostics12030600. View

18.

Van Boxem K, de Meij N, Kessels A, van Kleef M, Van Zundert J . Pulsed radiofrequency for chronic intractable lumbosacral radicular pain: a six-month cohort study. Pain Med. 2015; 16(6):1155-62. DOI: 10.1111/pme.12670. View

19.

Vanneste T, Van Lantschoot A, Van Boxem K, Van Zundert J . Pulsed radiofrequency in chronic pain. Curr Opin Anaesthesiol. 2017; 30(5):577-582. DOI: 10.1097/ACO.0000000000000502. View

20.

Konstantinou K, Dunn K . Sciatica: review of epidemiological studies and prevalence estimates. Spine (Phila Pa 1976). 2008; 33(22):2464-72. DOI: 10.1097/BRS.0b013e318183a4a2. View