The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
권호 표지
DOI QR코드

DOI QR Code

Results of Intradiscal Pulsed Radiofrequency for Lumbar Discogenic Pain: Comparison with Intradiscal Electrothermal Therapy

  • Fukui, Sei (Pain Management Clinic, Department of Anesthesiology, Shiga University of Medical Science Hospital) ;
  • Nitta, Kazuhito (Pain Management Clinic, Department of Anesthesiology, Shiga University of Medical Science Hospital) ;
  • Iwashita, Narihito (Pain Management Clinic, Department of Anesthesiology, Shiga University of Medical Science Hospital) ;
  • Tomie, Hisashi (Pain Management Clinic, Department of Anesthesiology, Shiga University of Medical Science Hospital) ;
  • Nosaka, Shuichi (Pain Management Clinic, Department of Anesthesiology, Shiga University of Medical Science Hospital) ;
  • Rohof, Olav (Orbis Medical Center, Pain Management Clinic)
  • Received : 2012.04.10
  • Accepted : 2012.05.29
  • Published : 2012.07.01
Download PDF
⟨ Previous Next ⟩

Abstract

Background: We have developed an intradiscal pulsed radiofrequency (Disc PRF) technique, using Diskit $II^{(R)}$ 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 $II^{(R)}$ 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 $5{\times}50$ 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 $7.2{\pm}0.6$ pretreatment to$2.5{\pm}0.9$ in the Disc PRF group, and from $7.5{\pm}1.0$ to $1.7{\pm}1.5$ 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

References

  1. Andersson GB. Epidemiology of low back pain. Acta Orthop Scand Suppl 1998; 281: 28-31.
  2. Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N. The prevalence and clinical features of internal disc disruption in patients with chronic low back pain. Spine (Phila Pa 1976) 1995; 20: 1878-83. https://doi.org/10.1097/00007632-199509000-00007
  3. Zhou Y, Abdi S. Diagnosis and minimally invasive treatment of lumbar discogenic pain--a review of the literature. Clin J Pain 2006; 22: 468-81. https://doi.org/10.1097/01.ajp.0000208244.33498.05
  4. Ohtori S, Kinoshita T, Yamashita M, Inoue G, Yamauchi K, Koshi T, et al. Results of surgery for discogenic low back pain: a randomized study using discography versus discoblock for diagnosis. Spine (Phila Pa 1976) 2009; 34: 1345-8. https://doi.org/10.1097/BRS.0b013e3181a401bf
  5. Saal JA, Saal JS. Intradiscal electrothermal treatment for chronic discogenic low back pain: Prospective outcome study with a minimum 2-year follow-up. Spine (Phila Pa 1976) 2002; 27: 966-73. https://doi.org/10.1097/00007632-200205010-00017
  6. Saal JA, Saal JS. Intradiscal electrothermal treatment for chronic discogenic low back pain: a prospective outcome study with minimum 1-year follow-up. Spine (Phila Pa 1976) 2000; 25: 2622-7. https://doi.org/10.1097/00007632-200010150-00013
  7. Pauza KJ, Howell S, Dreyfuss P, Peloza JH, Dawson K, Bogduk N. A randomized, placebo-controlled trial of intradiscal electrothermal therapy for the treatment of discogenic low back pain. Spine J 2004; 4: 27-35. https://doi.org/10.1016/j.spinee.2003.07.001
  8. Lutz C, Lutz GE, Cooke PM. Treatment of chronic lumbar diskogenic pain with intradiskal electrothermal therapy: a prospective outcome study. Arch Phys Med Rehabil 2003; 84: 23-8. https://doi.org/10.1053/apmr.2003.50059
  9. Appleby D, Andersson G, Totta M. Meta-analysis of the efficacy and safety of intradiscal electrothermal therapy (IDET). Pain Med 2006; 7: 308-16. https://doi.org/10.1111/j.1526-4637.2006.00172.x
  10. Freeman BJ. IDET: a critical appraisal of the evidence. Eur Spine J 2006; 15 Suppl 3: S448-57. https://doi.org/10.1007/s00586-006-0156-2
  11. Urrútia G, Kovacs F, Nishishinya MB, Olabe J. Percutaneous thermocoagulation intradiscal techniques for discogenic low back pain. Spine (Phila Pa 1976) 2007; 32: 1146-54. https://doi.org/10.1097/01.brs.0000261492.55121.93
  12. Teixeira A, Sluijter ME. Intradiscal high-voltage, long-duration pulsed radiofrequency for discogenic pain: a preliminary report. Pain Med 2006; 7: 424-8. https://doi.org/10.1111/j.1526-4637.2006.00138.x
  13. Rohof O. Intradiscal pulsed radiofrequency application following provocative discography for the management of degenerative disc disease and concordant pain: a pilot study. Pain Pract 2012; 12: 342-9. https://doi.org/10.1111/j.1533-2500.2011.00512.x
  14. Webster BS, Verma S, Pransky GS. Outcomes of workers' compensation claimants with low back pain undergoing intradiscal electrothermal therapy. Spine (Phila Pa 1976) 2004; 29: 435-41. https://doi.org/10.1097/01.BRS.0000092376.41688.1A
  15. Fujiwara A, Kobayashi N, Saiki K, Kitagawa T, Tamai K, Saotome K. Association of the Japanese Orthopaedic Association score with the Oswestry Disability Index, Roland-Morris Disability Questionnaire, and short-form 36. Spine (Phila Pa 1976) 2003; 28: 1601-7.
  16. Freemont AJ, Peacock TE, Goupille P, Hoyland JA, O'Brien J, Jayson MI. Nerve ingrowth into diseased intervertebral disc in chronic back pain. Lancet 1997; 350: 178-81. https://doi.org/10.1016/S0140-6736(97)02135-1
  17. Derby R, Seo KS, Kazala K, Chen YC, Lee SH, Kim BJ. A factor analysis of lumbar intradiscal electrothermal annuloplasty outcomes. Spine J 2005; 5: 256-61. https://doi.org/10.1016/j.spinee.2004.11.009
  18. Bogduk N. Pulsed radiofrequency. Pain Med 2006; 7: 396-407. https://doi.org/10.1111/j.1526-4637.2006.00210.x
  19. Cosman ER Jr, Cosman ER Sr. Electric and thermal field effects in tissue around radiofrequency electrodes. Pain Med 2005; 6: 405-24. https://doi.org/10.1111/j.1526-4637.2005.00076.x
  20. Chua NH, Vissers KC, Sluijter ME. Pulsed radiofrequency treatment in interventional pain management: mechanisms and potential indications-a review. Acta Neurochir (Wien) 2011; 153: 763-71. https://doi.org/10.1007/s00701-010-0881-5

Cited by

  1. Pulsed Radiofrequency of Non-neural Tissues vol.25, pp.4, 2012, https://doi.org/10.3344/kjp.2012.25.4.211
  2. Pulse-Dose Radiofrequency for Knee Osteoartrithis vol.37, pp.2, 2014, https://doi.org/10.1007/s00270-013-0694-z
  3. Operative Management of Lumbar Degenerative Disc Disease vol.10, pp.4, 2016, https://doi.org/10.4184/asj.2016.10.4.801
  4. A comprehensive review of pulsed radiofrequency in the treatment of pain associated with different spinal conditions vol.90, pp.1073, 2017, https://doi.org/10.1259/bjr.20150406
  5. Efficacy of Coblation Annuloplasty in Discogenic Low Back Pain vol.94, pp.19, 2015, https://doi.org/10.1097/MD.0000000000000846
  6. The genicular nerve: radiofrequency lesion application for chronic knee pain* vol.47, pp.13036165, 2017, https://doi.org/10.3906/sag-1601-171
  7. Effect of intradiscal pulsed radiofrequency on refractory chronic discogenic neck pain vol.97, pp.16, 2018, https://doi.org/10.1097/MD.0000000000010509
  8. Transforaminal epidural steroid injection combined with pulsed radio frequency on spinal nerve root for the treatment of lumbar disc herniation vol.11, pp.None, 2012, https://doi.org/10.2147/jpr.s174318
  9. Aseptic Spondylodiscitis Resulting from Intradiscal Radiofrequency Ablation (IDRA) in Patients with Herniated Disc Disease: A Report of Ten Cases vol.3, pp.1, 2012, https://doi.org/10.21182/jmisst.2017.00234
  10. Comparison of the Efficacy Between Intradiscal Gelified Ethanol (Discogel) Injection and Intradiscal Combination of Pulsed Radiofrequency and Gelified Ethanol (Discogel) Injection for Chronic Discogen vol.21, pp.11, 2020, https://doi.org/10.1093/pm/pnaa025
  11. Use of Pulsed Radiofrequency for the Treatment of Discogenic Back Pain: A Narrative Review vol.21, pp.5, 2012, https://doi.org/10.1111/papr.12978