Cheng-Chia Lee1, Ching-Jen Chen2, Chien-Chen Chou3, Hsin-Yi Wang4, Wen-Yuh Chung5, Giia-Sheun Peng6, Ching-Po Lin7. 1. Institute of Brain Research, National Yang-Ming University, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Neurosurgery, Hsin-chu branch, Taipei Veterans General Hospital, Hsin-chu, Taiwan; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. 2. Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, USA. 3. School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Neurology, Hsin-chu branch, Taipei Veterans General Hospital, Hsin-chu, Taiwan; Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. 4. School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Anaesthesiology, Hsin-chu branch, Taipei Veterans General Hospital, Hsin-chu, Taiwan. 5. School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Neurosurgery, Hsin-chu branch, Taipei Veterans General Hospital, Hsin-chu, Taiwan; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. 6. Department of Neurology, Hsin-chu branch, Taipei Veterans General Hospital, Hsin-chu, Taiwan. 7. Institute of Brain Research, National Yang-Ming University, Taipei, Taiwan; Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan. Electronic address: chingpolin@gmail.com.
Abstract
OBJECTIVES: In the study, we discuss the predictive value and cost-effectiveness of dorsal root ganglion (DRG) blocks before using dorsal root ganglion pulsed radiofrequency (DRG-PRF) in the treatment of low back pain. METHODS: The study comprised 60 patients with low back pain who were randomly assigned into 2 groups. Patients in group 1 were screened using DRG block before DRG-PRF treatment for responders. Patients in group 2 underwent DRG-PRF treatment without DRG block. Successful outcome was defined as patient satisfaction, improvement in numerical rating scale, and medication use reduction. RESULTS: In group 1 (n = 30), 24 patients demonstrated good response to DRG block, and 20 patients had successful outcome at 6 months after DRG-PRF therapy. In group 2 (n = 30), 25 of the patients had successful outcome at 6 months after DRG-PRF therapy. The mean medical costs were NT$ 19,245 and NT$ 16,375 for each successful case in groups 1 and 2, respectively. CONCLUSIONS: In this comparative cost-effectiveness study, the application of diagnostic DRG blocks before DRG-PRF did not have a significant impact on patient satisfaction, pain index score, or pain medication reduction. Furthermore, the application of diagnostic DRG blocks resulted in overall greater medical costs. These findings suggest that DRG-PRF without screening by DRG block is more cost-effective and less invasive.
RCT Entities:
OBJECTIVES: In the study, we discuss the predictive value and cost-effectiveness of dorsal root ganglion (DRG) blocks before using dorsal root ganglion pulsed radiofrequency (DRG-PRF) in the treatment of low back pain. METHODS: The study comprised 60 patients with low back pain who were randomly assigned into 2 groups. Patients in group 1 were screened using DRG block before DRG-PRF treatment for responders. Patients in group 2 underwent DRG-PRF treatment without DRG block. Successful outcome was defined as patient satisfaction, improvement in numerical rating scale, and medication use reduction. RESULTS: In group 1 (n = 30), 24 patients demonstrated good response to DRG block, and 20 patients had successful outcome at 6 months after DRG-PRF therapy. In group 2 (n = 30), 25 of the patients had successful outcome at 6 months after DRG-PRF therapy. The mean medical costs were NT$ 19,245 and NT$ 16,375 for each successful case in groups 1 and 2, respectively. CONCLUSIONS: In this comparative cost-effectiveness study, the application of diagnostic DRG blocks before DRG-PRF did not have a significant impact on patient satisfaction, pain index score, or pain medication reduction. Furthermore, the application of diagnostic DRG blocks resulted in overall greater medical costs. These findings suggest that DRG-PRF without screening by DRG block is more cost-effective and less invasive.