Combined radiofrequency for the treatment of lumbar discogenic radiculopathy
Keywords:discogenic pain, lumbosacral radiculopathy, thermodiscoplasty, pulsed radiofrequency
Introduction. Intervertebral disc degeneration often is a cause of low back pain (LBP) and reactive radicular pain. Thermodiscoplasty, or intradiscal electrothermal therapy (IDET) is used for minimally invasive treatment of discogenic pain. Pulsed radiofrequency (PRF) of the dorsal root ganglion (DRG) is used as an interventional method for radicular pain elimination.
Objective. To study the dynamics of pain syndrome and social adaptation in patients undergone combined treatment with the IDET and PRF DRG for chronic discogenic lumbosacral radiculopathies.
Materials and methods. A retrospective analysis of 20 patients treated at the Neuromed Clinic in Kyiv and the Pain Medicine Center in Kyiv was conducted. All patients had degenerative-dystrophic disease of intervertebral discs L4–L5 and L5–S1 with L4, L5, S1, S2 radiculopathy. A standard examination included biplane spondylography, MRI, and the neurological status assessment. The character of the pain was confirmed by a provocative contrast discography, the involvement of the corresponding spinal root was established during the selective radicular blockade. The results of the treatment were assessed using the visual-analogue pain scale (VAS) and the Oswestry Disability Index (ODI).
Results. No complications were found. Two patients (10 %) had unsatisfactory results in the form of a lack of positive dynamics. They underwent transforaminal endoscopic discotomy for up to 7 days. The rest of patients noted a significant reduction in pain. This tendency was keeping for 6 months.
Conclusions. The combined use of IDET and PRF DRG is an effective and safe method for the treatment of chronic lumbosacral discogenic radiculopathies.
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