Pulsed radiofrequency to lumbar dorsal root ganglion for lumbar radicular pain: A systematic review and meta-analysis
Sukhee Park1, Su-il Choi1, Ji-Hoon Park2
Department of Anesthesiology and Pain
Medicine, International St. Mary¡¯s Hospital, Catholic Kwandong University
School of Medicine, Incheon, Korea1, Department of Anesthesiology and Pain
Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu,
Korea2
Background : Pulsed radiofrequency (PRF) technique to lumbar dorsal root ganglion (DRG) has been used relieving lumbar radicular pain (LRP); however, it remains unclear that applying PRF to lumbar DRG has additional better outcomes than lumbar epidural injection. This study aimed to compare the effect of adjuvant PRF to lumbar DRG with lumbar epidural injections alone in patients with LRP.
Methods : A search was performed to identify randomized controlled trials (RCTs) that evaluated the effects of the PRF compared with a lumbar epidural injection. The pain scores and Oswestry Disability Index (ODI) at 1,3 and 6 months after procedures were retrieved. Primary outcomes were pain scores at 3 months after procedures. A literature search was performed using well-known databases for articles published up to July 2021.
Results : Seven RCTs were included and data from 371 patients were retrieved. The PRF exhibited better improved pain scores at 3 months with a mean difference (MD) of -1.19 (95% confidence interval [CI] -1.81 to -0.57). No significant difference was reported for the ODI score at 1, 3 and 6 months after procedure. In subgroup who did not use steroid, PRF significantly reduced pain scores at 3 months after procedure (MD -1.85 [95% CI -2.21 to -1.49]) suggesting a different analgesic effect of PRF according to the steroid use.
Concluions : The adjuvant PRF to lumbar DRG has better analgesic effect than lumbar epidural injection alone in LRP patients.