Results of pulsed radiofrequency technique with two laterally placed electrodes in the annulus in patients with chronic lumbar discogenic pain

• Published in: Journal of anesthesia Vol. 26; no. 4; pp. 606 - 609
• Main Authors: Fukui, Sei, Rohof, Olav
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.08.2012; Springer
• Subjects: Adult; Anesthesiology; Backache; Care and treatment; Chronic low back pain; Clinical Report; Critical Care Medicine; Disability Evaluation; Discogenic pain; Electrodes; Electrodes, Implanted; Emergency Medicine; Female; Fluoroscopy; Humans; Intensive; Intervertebral Disc Displacement - complications; Intradiscal procedures; Low Back Pain - etiology; Low Back Pain - therapy; Male; Medicine; Medicine & Public Health; Methods; Middle Aged; Pain; Pain Measurement; Pain Medicine; Pulsed radiofrequency; Pulsed Radiofrequency Treatment - adverse effects; Pulsed Radiofrequency Treatment - methods; Treatment Outcome; Intradiscal procedures; Chronic low back pain; Discogenic pain; Pulsed radiofrequency
• ISSN: 0913-8668; 1438-8359; 1438-8359
• DOI: 10.1007/s00540-012-1385-7

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.