Abstract

CANOVAS, L. et al. Intradiscal pulsed radiofrequency (Rf) and ozone in discogenic pain relief: experience in 51 cases. Rev. Soc. Esp. Dolor [online]. 2015, vol.22, n.1, pp.27-31. ISSN 1134-8046.  https://dx.doi.org/10.4321/S1134-80462015000100004.

Objective: About 40 % cases of lumbosacral pain has source in intervertebral disc. Degeneration and nucleus pulposus dehydration can produce tears in the annulus that stimulates growth irrigation and nocioceptors formation at this level and this could be the cause of discogenic pain. Intradiscal radiofrecuency (Rf) has 2B± evidence level for the discogenic pain relief. Our goal was to test if addition of intradiscal ozone to intradiscal Rf treatment could improve outcomes. Material and methods: Observational prospective study in which fifty-one patients with discogenic pain were treated. Inclusion criteria: a) Pain's evolution higher than eight months; b) VAS higher than seven; c) non radicular pain characteristics; d) lumbosacral pain with uni- or bilateral buttock irradiation; e) without response to pharmacologic and interventional treatment; f) discal degeneration o presence of a high-intensity zone in RM; g) discography with 30 % ozone: Not evidence of fuga to epidural space with addition of 3-8 ml ozone in nucleus pulposus. Patients were randomized in three groups: A - Just intradiscal ozone (3-8 ml). B - Intradiscal ozone and next RfP (2 Hz, 10 miliseg, 60 V) for 15 minutes (Neurotherm). C - Intradiscal - Pulsed Rf (with same parameters). Pulsed Rf parameters were recorded during the procedure: impedance, temperature, voltage and mA. Patients were evaluated at three and twelve months of the technique. Parameters evaluated were: EVA, improve percentage (no effect/EVA > 2/EVA > 50 %). Chosen statistical program was SPSS 16.0, t-student for average comparison, p-simple binomial for percentage comparison (p < 0.05). Results: More EVA reduction at three and twelve months on the B group (8.1 ± 1.1/3.7 ± 1.9/4 ± 2.2) (p < 0.01). All patients from B group significantly improve at three months and 88.2 % of the patients' improvement continuous for twelve months (p < 0.05). Conclusions: The association of intradiscal ozone with pulsed Rf can improve the results of the ozone's application in discogenic pain.

Keywords : Discal ozone; Pulsed radiofrecuency (RfP); Discogenic pain.

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