A real-world evidence of a consecutive treatment of 42 spine-related pain using dorsal root ganglion-pulsed radiofrequency (DRG-PRF)

Abstract

ObjectivesSpine-related pain is oftentimes not managed satisfactorily by analgesic medications and physiotherapy. Pulsed radiofrequency targeting on dorsal root ganglion (DRG-PRF) is able to precisely relieve pain without permanent damage to nervous tissue. In this article, we provide a short-term result of DRG-PRF for spine-related pain. Patients and MethodsA retrospective chart review of a consecutive of 42 patients who underwent PRF between 2015–2016 was conducted. All patients had received pharmaceutical treatment or physiotherapy before PRF. The diagnoses included cervicogenic headache, cervicalgia, upper back, middle back and lower back pain with or without radiculopathy. All of them were treated with DRG-PRF according to corresponding segmental dermatomes. Preoperative and postoperative 1-week, 1-month and 3-month numerical rating scale (NRS) and the usage of analgesic medicines were recorded and analyzed. ResultsThe mean age was 56.9 ± 14.8 years and 50 % of them were men. Seventy-six percent of patients underwent PRF had their pain originated from cervical and lumbar spine. Sixty percent of PRF procedures were to treat new chronic pain (duration less than 6 months). The preoperative NRS was 7.6 ± 1.1; the postoperative 1-week, 1-month and 3-month NRS were 2.5 ± 2.1, 3.0 ± 2.4 and 3.2 ± 2.4, respectively. DRG-PRF provided significantly NRS decrease in spine-related pain (p < 0.001). DRG-PRF also significantly decrease and deescalate the usage of analgesic medicines at postoperative 3 months (p < 0.001). The drop of NRS from preoperative state to postoperative 1 week was more significant in new chronic pain than in established chronic pain group (1.6 ± 1.4 vs. 3.0 ± 2.2, p = 0.015), however, both groups achieved similar pain reduction at postoperative 3 months (3.1 ± 2.2 vs. 3.3 ± 2.7, p = 0.903). No permanent neurological sequela was found, except 2 patients (4.7 %) had transient paresthesia with mild motor weakness after PRF which resolved within hours spontaneously. ConclusionDRG-PRF significantly decrease NRS and decrease and deescalate the usage of analgesic medicines in post-procedure 3 months in spine-related pain patients. DRG-PRF is effective for both new chronic and established chronic pain, and offers similar pain reduction for patients with radicular or non-radicular pain.