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Revista de la Sociedad Española del Dolor
versión impresa ISSN 1134-8046
Resumen
ABEJON, D. et al. Treatment of lumbar radiculopathy with pulsed radiofrequency. Rev. Soc. Esp. Dolor [online]. 2004, vol.11, n.6, pp.37-44. ISSN 1134-8046.
Objectives: To assess the effectiveness and side effects derived from the treatment with pulsed radiofrequency in patients diagnosed of lumbar radiculopathy. Material and methods: A prospective observational study was performed. Twenty pulsed radiofrequencies were performed in 17 consecutive patients with diagnosis of radioculopathy confirmed by electromyography and congruent clinical manifestations from January 2001 to January 2002. In all the patients and prior to the pulsed radiofrequency, a selective radicular blockade was performed. This blockade had to reduce patient symptomatology in at least 50% to be considered positive. Pain severity was assessed using a visual analogical scale at 5 different points in time: at the initial visit, at one month of treatment, at 2 months, at 3 months and at 6 months. The functional capacity of the patient was assessed using the Lattinen's test at the initial visit, at 3 months and at 6 months. The effectiveness of the technique was assessed using the 7-point Likert's scale, as well as the reduction of the treatment during the study period and the presence of complications. In order to compare the VAS scores obtained during the study period, a non-parametric Friedman's test was performed for paired data from multiple samples, applying a single-tailed contrast. A p-value < 0.05 was considered statistically significant. Results: The average age was 53.46 years (34-73), 7 women and 10 men, with an average time of evolution of 52.9 months (300-2). The average initial VAS score was 8 (10-4) with an average Lattinen index of 12.7 (15-9). Nine patients were receiving treatment with class I drugs, 6 with class 2 drugs and 2 with class 3 drugs. Root location was distributed as follows: 6 patients had affected the L5 root, 3 the S1 root, 1 the L2 root, 2 the L4 root and 4 the L5+S1 root. The average VAS score was reduced to 3.5 (2-7) at 1 month, to 3,3 (1-7) at 2 months, to 3.5 (0-7) at 3 months and to 3.8 (0-7) at 6 months. The Lattinen index was reduced to 6 at 3 months and was of 6.5 at 6 months. An statistically significant reduction of the VAS score was observed (p<0.001) in all the cases. Nine patients reduced their consumption of medication. There were no complications among the patients of this series. Conclusions: Pulsed radiofrequency seems to be a safe and promising technique for lumbar radicular pathologies, given its satisfactory results and the absence of side effects.
Palabras clave : Radiofrequency; Pulsed radiofrequency; Lumbar radioculopathy.