Pulsed Radiofrequency For Acute Back Pain and Sciatica

MedicalResearch.com Interview with:

Probe being applied to nerve root. Credit: Radiological Society of North America

Probe being applied to nerve root.
Credit: Radiological Society of North America

Alessandro Napoli MD PhD
Department of Radiological, Oncological and Pathological Sciences
Sapienza University of Rome 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Disc Herniation in the lumbar region can create intense pain in the lower back and along the leg as a result of nerve compression. People suffering disc herniation may either experience a spontaneous relief from the pain or requiring further medical actions in order to improve quality of life and going back to work and daily activities. When the pain is not responding to usual conservative care (both physical and pharmacological therapy) surgery is often considered a valid option.However, most of the people (despite the intense pain) would possibly avoid surgery. For this reason, Interventional percutaneous therapies such as intraforaminal injection of steroid have become more popular. Pulsed radiofrequency is a percutaneous therapy that may have the potential to rapidly relief the pain in a long lasting way by means of single 10 minutes procedure. We decided to undertook a randomized clinical trial to test the clinical benefit of pulsed radiofrequency therapy using intraforaminal injection as a control group. in both groups percutaneous approach was guided under precise guidance of CT images.

Pulsed radiofrequency group patients experience a faster and more durable pain control during the 1 year period follow up. Incidence of retreatment or cross-over was significantly higher in the injection only group.

MedicalResearch.com: What should readers take away from your report?

Response: Patient suffering lower back pain and sciatica as a result of lumbar disc herniation may undergo pulsed radiofrequency in a safe and effective manner. They may have a complete resolution of the symptoms and relative disability in a high percentage (79% according to our study) single 10-minutes CT-guided procedure. Responder patients did not require any further treatment and were indicated to physical exercise and improved life style. At 1 year follow up, patients considered complete responders showed herniation healing (irrespectively of sequestrated or contained disc hernia) at MRI as a result of the indirect effect of pain resolution.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response:  CT guided pulsed radiofrequency may represent a valid needle-based (percoutaneous) therapy for patient suffering disabling pain due to lumbar disc herniation refractory to standard care.


Dababou,S, Marrocchio,C, Erasmus,H, Scipione,R, Anzidei,M, Palla,C, Leonardi,A, Andrani,F, Napoli,A, Catalano,C, CT-Guided Pulsed Radiofrequency: A Minimally-Invasive Procedure for Acute Radicular Low Back Pain. Radiological Society of North America 2018 Scientific Assembly and Annual Meeting, November 25 – November 30, 2018, Chicago IL. archive.rsna.org/2018/18019859.html Accessed November 24, 2018



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