Korean J Pain.  2019 Oct;32(4):280-285. 10.3344/kjp.2019.32.4.280.

The effect of needle tip position on the analgesic efficacy of pulsed radiofrequency treatment in patients with chronic lumbar radicular pain: a retrospective observational study

• Kim WJ
• Park HS
• Park MK

• KMID: 2462838
• DOI: http://doi.org/10.3344/kjp.2019.32.4.280

Abstract

BACKGROUND
Pulsed radiofrequency (PRF) is a treatment modality that alleviates radicular pain by intermittently applying high-frequency currents adjacent to the dorsal root ganglion. There has been no comparative study on analgesic effect according to the position of the needle tip in PRF treatment. The objective of this study is to evaluate the clinical outcomes of PRF according to the needle tip position.
METHODS
Patients were classified into 2 groups (group IP [group inside of pedicle] and group OP [group outside of pedicle]) based on needle tip position in the anteroposterior view of fluoroscopy. In the anteroposterior view, the needle tip was advanced medially further than the lateral aspect of the corresponding pedicle in group IP; however, in group OP, the needle tip was not advanced. The treatment outcomes and pain scores were evaluated at 4, 8, and 12 weeks after applying PRF.
RESULTS
At 4, 8, and 12 weeks, there were no significant differences between the successful response rate and numerical rating scale score ratio.
CONCLUSIONS
The analgesic efficacy of PRF treatment did not differ with the needle tip position.

Keyword

Analgesics; Ganglia, Spinal; Low Back Pain; Lumbosacral Region; Needles; Pulsed Radiofrequency Treatment; Radiculopathy; Spinal Nerve Roots

MeSH Terms

Analgesics
Fluoroscopy
Ganglia, Spinal
Humans
Low Back Pain
Lumbosacral Region
Needles*
Observational Study*
Pulsed Radiofrequency Treatment*
Radiculopathy
Retrospective Studies*
Spinal Nerve Roots
Analgesics

Figure

• 

  Fig. 1 Determination of the dorsal root ganglion (DRG) position. A and B are lines connecting the medial and lateral borders of the pedicles, respectively. If the midpoint of the DRG lies proximal to A, it is intraspinal type. If it is between A and B, it is foraminal type. If it is distal to B, it is extraforaminal type.

• 

  Fig. 2 Position of the needle tip. (A) The needle tip was advanced medially further than the lateral aspect of the corresponding pedicle. (B) The needle tip was in the lateral aspect of the corresponding pedicle. P: pedicle.

• 

  Fig. 3 Flow diagram of the patient inclusion process. MRI: magnetic resonance imaging, PRF: pulsed radiofrequency, DRG: dorsal root ganglion, Group IP: group inside of pedicle, Group OP: group outside of pedicle.

• 

  Fig. 4 Numerical rating scale (NRS). Group IP: group inside of pedicle, Group OP: group outside of pedicle. *P < 0.05 relative to baseline.

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