Poster Presentations

Session Title: Treatment Approaches: Interventional
Presentation Date: Saturday, March 14, 2009

PULSED RADIOFREQUENCY DORSAL ROOT GANGLION LESIONING IN PATIENTS WITH HERNIATED LUMBAR DISCS WITH RADICULAR PAIN

K. Kothari
Pain Clinic Of India, Pain Management, Mumbai, India

Material and methods: Total 50 Patients dignosed as lumbar disc herniation on MRI scan causing radiculopathy included for the study. In prone position, oblique fluoroscopic view 10cm long 20 G 5mm active tip epimed RFcannula inserted & guided to lie in the foramen. Sensory stimulation at 50Hz achieved < 0.3V & Motor stimulation (2 Hz) achieved at 1.5-2 times the sensory threshold. 0.25% sensorcaine 0.5ml injected, Pulsed RF current delivered by Neurotherm JK 25 RF generator at 42oC,45V for 8mins. Patients were discharged after 2-3 hours. Follow up was done at 3, 7, 15, 30, 60, 150 days post procedure.
Observations: Questionnaire included overall pain relief as indicated by VAS, quality of life, ability to do routine day to day work. VAS was taken as the main indicator of pain relief in our study. The Average VAS was 6.5 pre procedure & post procedure 1.7 at 2 months & 2.6 at 6 months. This is clinically & statistically significant difference. There were no complications seen in this series. There was no motor or sensory loss in lower limb seen in any case.
Discussion: Recently, a safer alternative to Percutaneous RF neurotomy has emerged in the medical literature whereby the targeted neural tissue is subjected to high frequency (300-500-kHz), relatively low voltage (around 40-60 volts) RF pulses rather than coagulation by continuous, high temperature RF current.The mode of action of pulsed RF is not understood.
Conclusion: Our study has shown significant pain relief in most of the patients who underwent pRF DRG treatment. The results are promising, but more controlled studies are needed in future.