A novel radiofrequency thermocoagulation method for treatment of lower back pain: thermal conduction after instillation of saline solution into the nucleus pulposus--preliminary results.

Abstract

BACKGROUND:

Radiofrequency heating of the intervertebral disc has been proposed for the treatment of chronic low back pain using two methods: a flexible needle inserted into the annulus fibrosus achieving a full 360 degrees penetration, or a rigid needle inserted into the nucleus pulposus. The first technique is effective on pain, but the clinical benefit of the second is uncertain.

PURPOSE:

To evaluate a technique for radiofrequency heating of the lumbar intervertebral disc by a needle placed into the nucleus pulposus.

MATERIAL AND METHODS:

The method was tested in 17 patients according to the criteria used in previous intradiscal radiofrequency studies. Before and after treatment, disability was assessed by the Oswestry disability score. A pain reduction of at least 50% was considered a success.

RESULTS:

Fifteen patients were responders at 1 month (88%), nine at 3 months (53%), and 12 at 6 months (70.6%). No complications were observed.

CONCLUSION:

A new method of providing discal radiofrequency treatment for lower back pain had a substantial clinical benefit in 71% of the observed patients. A prospective study comparing this new method with placebo should be conducted to confirm these initial results.

• Authors: N Azulay, M Forgerit, E G Alava, A Deplas, R Vialle, S Ragot, J-P Tasu
• Journal: Acta radiologica (Stockholm, Sweden : 1987) (Acta Radiol) Vol. 49 Issue 8 Pg. 934-9 (Oct 2008) ISSN: 1600-0455 [Electronic] England
• PMID: 18618349 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Sodium Chloride

Topics

• Adult
• Catheter Ablation (methods)
• Cohort Studies
• Female
• Follow-Up Studies
• Humans
• Intervertebral Disc (surgery)
• Low Back Pain (surgery)
• Male
• Middle Aged
• Minimally Invasive Surgical Procedures (methods)
• Pain Measurement (methods, statistics & numerical data)
• Retrospective Studies
• Sodium Chloride (administration & dosage)
• Thermal Conductivity