Koen Van Boxem1, Nelleke de Meij2, Jacob Patijn3, Jan Wilmink4, Maarten van Kleef5, Jan Van Zundert6, Alfons Kessels7. 1. Departments of *Anesthesiology and Pain Management, Department of Anesthesiology, Critical Care and Multidisciplinary Pain Center, Sint-Jozefkliniek, Bornem & Willebroek, Belgium; koen.vb@telenet.be. 2. Departments of *Anesthesiology and Pain Management, koen.vb@telenet.be. 3. Departments of *Anesthesiology and Pain Management. 4. Radiology, and. 5. Departments of *Anesthesiology and Pain Management, Department of Anesthesiology and Pain Management, VUMC Amsterdam, The Netherlands; 6. Departments of *Anesthesiology and Pain Management, Department of Anesthesiology, Critical Care and Multidisciplinary Pain Center, ZOL, Genk, Belgium. 7. Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, The Netherlands;
Abstract
BACKGROUND: In a previous prospective study on pulsed radiofrequency (PRF) treatment adjacent to the lumbar dorsal root ganglion (DRG) for patients with chronic lumbosacral radicular pain, we reported success in 55.4% of the patients at 6 months. Identification of predictors for success after PRF may improve outcome. We assessed the predictors of PRF in patients with chronic intractable lumbosacral radicular pain. METHODS: Patients with monosegmental chronic lumbosacral radicular pain of L5 or S1 first received a selective nerve root block at the corresponding level. Independent of the result of this block a PRF treatment at the same level was performed. At 6 weeks, 3 months, and 6 months after the procedure the outcome was evaluated. RESULTS: A positive diagnostic nerve root block and age ≥ 55 were predictive factors for successful outcome at 6 months, while disability was a negative predictor.The use of failed back surgery syndrome, gender, duration of pain, Numerical Rating Scale, level and side of treatment, DN4, and RAND-36 as predictors for success was not supported. CONCLUSIONS: Successful outcome after PRF adjacent to the DRG, in patients with intractable chronic lumbosacral radicular pain, is more likely in patients ≥ 55 years, with limited disability and after a positive diagnostic nerve root block. A combination of all these factors creates a fair predictive value (AUC: 0.73).
BACKGROUND: In a previous prospective study on pulsed radiofrequency (PRF) treatment adjacent to the lumbar dorsal root ganglion (DRG) for patients with chronic lumbosacral radicular pain, we reported success in 55.4% of the patients at 6 months. Identification of predictors for success after PRF may improve outcome. We assessed the predictors of PRF in patients with chronic intractable lumbosacral radicular pain. METHODS:Patients with monosegmental chronic lumbosacral radicular pain of L5 or S1 first received a selective nerve root block at the corresponding level. Independent of the result of this block a PRF treatment at the same level was performed. At 6 weeks, 3 months, and 6 months after the procedure the outcome was evaluated. RESULTS: A positive diagnostic nerve root block and age ≥ 55 were predictive factors for successful outcome at 6 months, while disability was a negative predictor.The use of failed back surgery syndrome, gender, duration of pain, Numerical Rating Scale, level and side of treatment, DN4, and RAND-36 as predictors for success was not supported. CONCLUSIONS: Successful outcome after PRF adjacent to the DRG, in patients with intractable chronic lumbosacral radicular pain, is more likely in patients ≥ 55 years, with limited disability and after a positive diagnostic nerve root block. A combination of all these factors creates a fair predictive value (AUC: 0.73).
Authors: Kliment Gatzinsky; Sam Eldabe; Jean-Philippe Deneuville; Wim Duyvendak; Nicolas Naiditch; Jean-Pierre Van Buyten; Philippe Rigoard Journal: Pain Res Manag Date: 2019-07-08 Impact factor: 3.037