Pain Medicine 2014; ••: ••–•• Pain Medicine 2015; Wiley Periodicals, Inc.16: 432–441 Wiley Periodicals, Inc.
Treatment of Chronic Lumbosacral Radicular Pain Using Adjuvant Pulsed Radiofrequency: A Randomized Controlled Study
Wonuk Koh, MD, PhD,* Seong-Soo Choi, MD, PhD,* Myong Hwan Karm, MD,* Jeong Hun Suh, MD, PhD,* Jeong Gil Leem, MD, PhD,* Jae Do Lee, MD,† Young Ki Kim, MD, PhD,‡ and Jinwoo Shin, MD, PhD* *Department of Anesthesiology and Pain Medicine, Asan Medical Center, College of Medicine, University of Ulsan, †Department of Anesthesiology and Pain Medicine, VHS Medical Center, Seoul; ‡Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung, Korea Reprint requests to: Jinwoo Shin, MD, PhD, Department of Anesthesiology and Pain Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 388-1, Pungnap-2Dong, Songpa-Gu, Seoul, Korea. Tel: +82-2-3010-3864; Fax: +82-2-3010-6790; E-mail: [email protected]. Institutional review: This study was approved by the Institutional Review Board of the Asan Medical Center, Seoul, Korea. Disclosure: Our institute has not used particulate steroids in epidural injections (caudal, interlaminar, or transforaminal) since January 2013, and the intrathecal or epidural injection of triamcinolone acetonide was restricted by the Korean Ministry of Food and Drug Safety on March 15, 2013. However, triamcinolone acetonide was used in epidural injections until December 2012 at our clinic, and, because this study was carried out between October 2011 and July 2012, triamcinolone acetonide was administered to the study patients. Conflicts of interest: There are no conflicts of interest to report.
Abstract Objectives. The objective of this study was to determine the effects of combining pulsed radiofrequency (PRF) treatment and transforaminal epidural injection (TFEI) to treat patients with chronic refractory lumbar radicular pain caused by lumbar spinal stenosis. Study design. Randomized control trial. Settings. Interventional pain management practice. Method. Sixty-two patients were assigned to the study groups (PRF group = 31; control group = 31). Under fluoroscopic guidance, the RF needle was positioned close to the lumbar dorsal root ganglion. The PRF group received 3 cycles of PRF treatment, and sensory stimulation without RF lesioning was applied to the control group. After PRF or sham lesioning, a local anesthetic with steroid was injected. The primary outcome of a successful response was defined as: 1) ≥50% or 4–point pain reduction in the numerical rating scale (NRS) without an increase in the Oswestry disability index (ODI) or medication quantification scale (MQS), or mean score
Treatment of Chronic Lumbosacral Radicular Pain Using Adjuvant Pulsed Radiofrequency: A Randomized Controlled Study
Wonuk Koh, MD, PhD,* Seong-Soo Choi, MD, PhD,* Myong Hwan Karm, MD,* Jeong Hun Suh, MD, PhD,* Jeong Gil Leem, MD, PhD,* Jae Do Lee, MD,† Young Ki Kim, MD, PhD,‡ and Jinwoo Shin, MD, PhD* *Department of Anesthesiology and Pain Medicine, Asan Medical Center, College of Medicine, University of Ulsan, †Department of Anesthesiology and Pain Medicine, VHS Medical Center, Seoul; ‡Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung, Korea Reprint requests to: Jinwoo Shin, MD, PhD, Department of Anesthesiology and Pain Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 388-1, Pungnap-2Dong, Songpa-Gu, Seoul, Korea. Tel: +82-2-3010-3864; Fax: +82-2-3010-6790; E-mail: [email protected]. Institutional review: This study was approved by the Institutional Review Board of the Asan Medical Center, Seoul, Korea. Disclosure: Our institute has not used particulate steroids in epidural injections (caudal, interlaminar, or transforaminal) since January 2013, and the intrathecal or epidural injection of triamcinolone acetonide was restricted by the Korean Ministry of Food and Drug Safety on March 15, 2013. However, triamcinolone acetonide was used in epidural injections until December 2012 at our clinic, and, because this study was carried out between October 2011 and July 2012, triamcinolone acetonide was administered to the study patients. Conflicts of interest: There are no conflicts of interest to report.
Abstract Objectives. The objective of this study was to determine the effects of combining pulsed radiofrequency (PRF) treatment and transforaminal epidural injection (TFEI) to treat patients with chronic refractory lumbar radicular pain caused by lumbar spinal stenosis. Study design. Randomized control trial. Settings. Interventional pain management practice. Method. Sixty-two patients were assigned to the study groups (PRF group = 31; control group = 31). Under fluoroscopic guidance, the RF needle was positioned close to the lumbar dorsal root ganglion. The PRF group received 3 cycles of PRF treatment, and sensory stimulation without RF lesioning was applied to the control group. After PRF or sham lesioning, a local anesthetic with steroid was injected. The primary outcome of a successful response was defined as: 1) ≥50% or 4–point pain reduction in the numerical rating scale (NRS) without an increase in the Oswestry disability index (ODI) or medication quantification scale (MQS), or mean score
