• RF FOR LUMBAR PAIN
• RF FOR SACROILIAC JOINT PAIN
• PULSED RF FOR RADICULAR PAIN
• RF FOR CEREVICAL PAIN

STUDY GOAL

To investigate the effect of bipolar Pulsed Radio Frequency (bPRF) stimulation of the DRG in patients with chronic lumbosacral radicular pain who were unresponsive to transforaminal epidural steroid injection (TFESI). The authors also compared the effect of bPRF to that of monopolar PRF (mPRF).

METHODOLOGY

Patients: 50 patients with chronic lumbosacral radicular pain, refractory to TFESI, were recruited and randomly assigned to one of two groups; the bPRF (N=25) or mPRF (N=25).

• All patients had a longer than 6-months history of lumbar or sacral segmental pain radiating from the back toward the leg.
• Imaging findings confirmed either herniated lumbar disc or lumbosacral stenosis in the patients.
• Pain intensity was assessed by a blinded investigator using a numeric rating scale (NRS) at pre-treatment, and 1, 2, and 3 months after treatment. Successful treatment was defined as more than 50% reduction in NRS scores at 3 months follow-up.

PRF procedure: The affected DRG was punctured with one (mPRF) or two (bPRF) catheter needles (active tip electrodes) under fluoroscopy guidance. A sensory test was performed using an RF Generator (Cosman G4) until the patients reported a tingling sensation or dysesthesia, at less than 0.3V.

The PRF treatment was administered at 45V; 5ms PW; 5Hz for 360 seconds. The electrode tip did not exceed 42°C.

RESULTS

• NRS scores in both bPRF and mPRF groups showed a significant reduction at 1, 2, and 3 months after treatment, compared to baseline scores.
• NRS scores decline over time was significantly larger in the bPRF group, compared to mPRF group, at all follow-up time points.
• The rate of successful pain relief at 3-months posttreatment was significantly better for the bRFA group (76%) than for the mRFA (48%).
• The number of patients who used analgesics and calcium channel antagonists decreased dramatically for both treatment groups.