MedicalResearch.com Interview with:
Dr. Alessandro Napoli
Dipartimento di Scienze Radiologiche
Unità di Terapia con Ultrasuoni Focalizzati
Sapienza Università di Roma, Policlinico Umberto I
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Low back pain and sciatica are very common conditions affecting at least 80% of the population (once in life) with detrimental impact on quality of life. Pain cause is often a lumbar disc herniation with sciatic nerve compression. Treatment strategy is primarily conservative (drugs and physical therapy) and when symptoms are persisting for more than 4 consecutive weeks, surgery is advocated.
Many patients prefer to avoid surgery for multiple reasons (recurrence rate, risk-related to the intervention and post-surgical sequela).
Technology advances with percutaneous techniques allowed more recently to fill the gap between conservative strategy and surgery for the management of lumbar disc herniation and related low back pain extending to the leg(s). Patients are offered local injection for symptoms relief with limited results. Therefore, other non-to-mini invasive approaches are clinically tested for prolonged clinical efficacy. Pulsed radiofrequency is a promising percutaneous approach mainly used for chronic pain. We aimed to test pulsed radiofrequency in patients refractory to conservative treatments, indicated to surgery.
Our study demonstrated that radiofrequency with pulsed technique, performed under CT image guidance, is able to control pain in a surgical-free, single session, lasting 10 minutes. The procedure is highly attractive since can be considered nearly risk-free with high rate of success. In our series 80% of patients treated with pulsed radiofrequency resulted pain free (VAS pain score 0 out of 10) at 1, 3 and 12 months follow-up; 90% did not required anymore surgery.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Low back pain and sciatica due to disc herniation can be treated in acute and subacute setting using single session Pulsed radio frequency. This is a non-surgical highly precise technique that restores sciatic nerve function and resolves nerve inflammation.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Further study needed to confirm long-term results (greater than 1 y).
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
CT guided Pulsed radiofrequency treatment of the lumbar dorsal root ganglion in patients with Acute Radicular Low Back Pain
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