THE OUTCOME OF PULSED RADIOFREQUENCY TREATMENT OF THE DORSAL ROOT VS LUMBAR NERVE ROOT INJECTION IN PATIENT AFFECTED BY LUMBAR RADICULOPATHY
Bibliographic record
Abstract
IntroductionDegenerative disc disease (DDD) of the lumbar spine is a common pathology affecting a high percentage of people. Extraforaminal nerve root compression at the lateral recess is associated with chronic neuropathic pain, presumably caused by direct compression of the dorsal root ganglion by the prolapse disc. There is little evidence regarding the effectiveness of medical management of lumbosacral radicular pain. Pulsed radiofrequency (PRF) treatment of the dorsal root ganglion (DRG) has been used as a minimally invasive treatment of lumbar radicular pain (1, 2) as an alternative treatment to lumbar nerve root injection (LNRI) with steroids (4)MethodWe treated a total of 28 patients affected by unilateral lumbar radiculopathy due to degenerative disc disease, as shown at the MRI scan, with pulsed radiofrequency treatment (PRF) of the dorsal ganglia (15 patients) or lumbar nerve root injection (NLRI) with methylprednisolone (13 patients). They were 10 female and 5 males in the PRFT group, and 7 female and 6 males in the NLRI group. The average age was similar in both groups (59 years in the PRF group and 60 years in the NLRI). The PRF treatment was performed for 300 seconds at 42 u00baC temperature degree and the NLRI with a total of 10 mls of 80 mg methylprednisolone (2 mls) and chirocaine 2.5g/ml (8mls). Both procedures were undertaken under fluoroscopic guidance in a full sterile condition. Patients completed a VAS and McGill questionnaire at baseline and at 12 weeks follow up.ResultsBoth groups showed a statistically significant improvement at 12 weeks when compared it to baseline. There was not statistical difference in VAS and McGill scores between the two groups, although there was a trend of better outcome in the PRF group compared to the NLRI group. The mean VAS baseline was 5.99 u00b1 0.95 in the PRF group and 6.18 u00b1 0.84 in the N LRI group. The mean McGill baseline score was 28.07 u00b1 8.65 in the PRF group and 29.08 u00b1 5.42 in the NLRI group. At 12 weeks the mean VAS was 4.73 u00b11.61 (p value: < 0.001) in the PRF group and 4.95 u00b1 1.33 (p value: p <0.01) in the NLRI group. The mean McGill score at 12 weeks was 20.,53 u00b1 8.77 (p value: <0.01) in the PRF group and 24.62 u00b1 7.56 (p value: <0.05) in the NLRI group. The data was expressed in mean u00b1 SD; t-Student test was employed to calculate statistical significance. ConclusionOur pilot study showed that both treatments were effective in providing pain relief and better quality of life at 12 weeks. There was no statistical difference between the two groups. However, the PRF group achieved better results. A large study is needed to assess the difference, if any, between the two treatments.Reference1.tVan Boxem K, de Meij N, Kessels A, Van Kleef M, Van Zundert J. Pulsed radiofrequency for chronic intractable lumbosacral radicular pain: a six-month cohort study. Pain Med. 2015 Jun;16(6):1155-62. Epub 2015 Jan 8 2.tKoh W1, Choi SS, Karm MH, Suh JH, Leem JG, Lee JD, Kim YK, Shin J. Treatment of chronic lumbosacral radicular pain using adjuvant pulsed radiofrequency: a randomized controlled study. Pain Med. 2015 Mar;16(3):432-41. Epub 2014. 3.tKoh W, Choi SS, Karm MH, Suh JH, Leem JG, Lee JD, Kim YK, Shin J. Treatment of chronic lumbosacral radicular pain using adjuvant pulsed radiofrequency: a randomized controlled study. Pain Med. 2015 Mar;16(3):432-41. Epub 2014 4.tJonayed SA, Kamruzzaman M, Saha MK, Alam S, Akter S. The Role of Selective Nerve Root Block in the Treatment of Lumbar Radicular Leg Pain. Mymensingh Med J. 2016 Jan;25(1):141-7.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.012 | 0.019 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.002 | 0.007 |
| Open science | 0.012 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".