Predictive Factors for Successful Outcome of Pulsed Radiofrequency Treatment in Patients with Intractable Lumbosacral Radicular Pain

被引:19
作者
Van Boxem, Koen [1 ,4 ,5 ]
de Meij, Nelleke [1 ]
Patijn, Jacob [1 ]
Wilmink, Jan [2 ]
van Kleef, Maarten [1 ,6 ]
Van Zundert, Jan [1 ,7 ]
Kessels, Alfons [3 ]
机构
[1] Maastricht Univ, Med Ctr, Dept Anesthesiol & Pain Management, POB 5800, NL-6202 AZ Maastricht, Netherlands
[2] Maastricht Univ, Med Ctr, Dept Radiol, NL-6200 MD Maastricht, Netherlands
[3] Maastricht Univ, Med Ctr, Dept Clin Epidemiol & Med Technol Assessment, NL-6200 MD Maastricht, Netherlands
[4] Sint Jozefklin, Crit Care & Multidisciplinary Pain Ctr, Dept Anesthesiol, Bornem, Belgium
[5] Sint Jozefklin, Crit Care & Multidisciplinary Pain Ctr, Dept Anesthesiol, Willebroek, Belgium
[6] VUMC Amsterdam, Dept Anesthesiol & Pain Management, Amsterdam, Netherlands
[7] ZOL, Dept Anesthesiol, Crit Care & Multidisciplinary Pain Ctr, Genk, Belgium
关键词
Radiofrequency; Lumbosacral radicular pain; Pulsed radiofrequency; Dorsal root ganglion; Predictive; DORSAL-ROOT GANGLION; LOW-BACK-PAIN; NEUROPATHIC PAIN; PROGNOSTIC-FACTORS; DISC HERNIATION; LISSAUER TRACT; ACUTE SCIATICA; A-DELTA; QUESTIONNAIRE; MANAGEMENT;
D O I
10.1093/pm/pnv052
中图分类号
R614 [麻醉学];
学科分类号
100217 [麻醉学];
摘要
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 a parts per thousand yen 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 a parts per thousand yen 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).
引用
收藏
页码:1233 / 1240
页数:8
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