González-Ramos L, Hermida-Ochoa E, Benavides-Rodríguez D, Hermida-Ochoa J

Language: Spanish
References: 21
Page: 152-158
PDF size: 192.23 Kb.

ABSTRACT

Introduction: lumbar spine pain affects a high percentage of the population and has a significant socioeconomic impact. Lumbar facet syndrome has a prevalence between 15-31% with lifetime incidence of up to 52% in some series. Due to the use of different types of treatment and different patient selection criteria, the success rate varies in the literature. Objective: to compare results of treatment with rhizolysis applying pulsed radiofrequency versus cryoablation in patients diagnosed with lumbar facet syndrome. Material and methods: from January 2019 to November 2019, eight patients were randomly divided into two groups: group A treated with pulsed radiofrequency and group B treated with cryoablation. Pain was assessed with the visual analogue scale and the Oswestry low back pain disability index at four weeks, in addition to three and six months. Results: follow-up was six months. Immediately the eight patients (100%) reported improvement in symptoms and pain. Of the four patients who were in intense functional limitation, one of them became without functional limitation, and two of them went to minimum functional limitation and one to moderate functional limitation at the first month, statistically significant differences were reported. Conclusions: both treatments control pain in the short term; there is also an improvement in physical abilities. The morbidity accompanying neurolysis either radiofrequency or cryoablation is very low.

REFERENCES

1. Muñoz V, Pérez JJ, Pérez-Cajaraville JJ, Berjano E. Aspectos teóricos sobre la biofísica de la radiofrecuencia aplicada al tratamiento del dolor. Rev Soc Esp Dolor. 2014; 21(6): 351-8.

2. Hernández Carbajal B. Dolor vertebral tratamiento médico y cirugía mínimamente invasiva. Capítulo 4: Dolor de la columna vertebral lumbar. México: Corinter; 2012. pp. 41-73.

3. Trinidad JM, Carnota AI, Failde I, Torres LM. Radiofrequency for the treatment of lumbar radicular pain: impact on surgical indications. Pain Res Treat. 2015; 2015: 392856.

4. Nagda JV, Davis CW, Bajwa ZH, Simopoulos TT. Retrospective review of the efficacy and safety of repeated pulsed and continuous radiofrequency lesioning of the dorsal root ganglion/segmental nerve for lumbar radicular pain. Pain Physician. 2011; 14(4): 371-6.

5. Martín-Arroyo JMT. Radiofrecuencia pulsada: pasan los años y seguimos con las mismas incógnitas. Rev Soc Esp Dolor. 2016; 23(4): 167-9.

6. Manchikanti L, Singh V, Falco FJ, Benyamin RM, Hirsch JA. Epidemiology of low back pain in adults. Neuromodulation. 2014; 17 Suppl 2: 3-10.

7. Shanthanna H, Chan P, McChesney J, Paul J, Thabane L. Assessing the effectiveness of 'pulse radiofrequency treatment of dorsal root ganglion' in patients with chronic lumbar radicular pain: study protocol for a randomized control trial. Trials. 2012; 13: 52.

8. Lin ML, Lin WT, Huang RY, Chen TC, Huang SH, Chang CH, et al. Pulsed radiofrequency inhibited activation of spinal mitogen-activated protein kinases and ameliorated early neuropathic pain in rats. Eur J Pain. 2014; 18(5): 659-70.

9. Vallejo R, Tilley DM, Williams J, Labak S, Aliaga L, Benyamin RM. Pulsed radiofrequency modulates pain regulatory gene expression along the nociceptive pathway. Pain Physician. 2013; 16(5): E601-13.

10. Sluijter ME, Imani F. Evolution and mode of action of pulsed radiofrequency. Anesth Pain Med. 2013; 2(4): 139-41.

11. Chua NHL, Vissers KC, Sluijter ME. Pulsed radiofrequency treatment in interventional pain management: Mechanisms and potential indications-a review. Acta Neurochir. 2010; 153(4): 763-71.

12. van Boxem K, Joosten EA, van Kleef M, Patijn J, van Zundert J. Pulsed radiofrequency treatment for radicular pain: where do we stand and where to go? Pain Med. 2012; 13(3): 351-4.

13. Van Zundert J, Vanelderen P, Kessels A, van Kleef M. Radiofrequency treatment of facet-related pain: evidence and controversies. Curr Pain Headache Rep. 2012; 16(1): 19-25.

14. Gallagher RM. Pulsed radiofrequency treatment: Biological mechanisms and clinical evidence. Pain Med. 2005; 6(6): 401-2.

15. Maas ET, Ostelo RW, Niemisto L, Jousimaa J, Hurri H, Malmivaara A, et al. Radiofrequency denervation for chronic low back pain. Cochrane Database Syst Rev. 2015; 2015(10): CD008572.

16. Tekin I, Mirzai H, Ok G, Erbuyun K, Vatansever D. A comparison of conventional and pulsed radiofrequency denervation in the treatment of chronic facet joint pain. Clin J Pain. 2007; 23(6): 524-9.

17. Kroll HR, Kim D, Danic MJ, Sankey SS, Gariwala M, Brown M. A randomized, double-blind, prospective study comparing the efficacy of continuous versus pulsed radiofrequency in the treatment of lumbar facet syndrome. J Clin Anesth. 2008; 20(7): 534-7.

18. Colini-Baldeschi G. Evaluation of pulsed radiofrequency denervation in the treatment of chronic facetjoint pain: an observational study. Anesth Pain Med. 2012; 1(3): 168-73.

19. Cahana A, Van Zundert J, Macrea L, van Kleef M, Sluijter M. Pulsed radiofrequency: current clinical and biological literature available. Pain Med. 2006; 7(5): 411-23.

20. Liliang PC, Lu K, Liang CL, Tsai YD, Hsieh CH, Chen HJ. Pulsed radiofrequency lesioning of the suprascapular nerve for chronic shoulder pain: a preliminary report. Pain Med. 2009; 10(1): 70-5.

21. Gofeld M, Restrepo-Garces CE, Theodore BR, Faclier G. Pulsed radiofrequency of suprascapular nerve for chronic shoulder pain: a randomized double-blind active placebo-controlled study. Pain Pract. 2013; 13(2): 96-103.

EVIDENCE LEVEL

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