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- Title
Transforaminal Epidural Injection of Local Anesthetic and Dorsal Root Ganglion Pulsed Radiofrequency Treatment in Lumbar Radicular Pain: A Randomized, Triple‐Blind, Active‐Control Trial.
- Authors
De, Manish; Mohan, Virender K.; Bhoi, Debesh; Talawar, Praveen; Kumar, Ajeet; Garg, Bhavuk; Trikha, Anjan; Dehran, Maya; Kashyap, Lokesh; Shende, Dilip R.
- Abstract
Background: Lumbar radicular pain (LRP) results from inflammation and irritation of lumbar spinal nerves and the dorsal root ganglion (DRG). Methods: Our study is a prospective, triple‐blind, randomized, activecontrol trial (CTRI/2016/02/006666) comparing transforaminal epidural local anesthetic (LA) injection and pulsed radiofrequency treatment of DRG in patients with chronic LRP. Patients with LRP after failed conservative management for >3 months received selective diagnostic nerve root block with 1 mL 2% lidocaine. Fifty patients showing positive responses were divided into groups of 25 each. The LA group received transforaminal epidural injection of 1 mL 0.5% bupivacaine. The lumbar pulsed radiofrequency (LPRF) group received transforaminal epidural injection of 1 mL 0.5% bupivacaine with 3 cycles of pulsed radiofrequency of the DRG for 180 seconds Results: Both groups were compared by observing pain intensity on a 0‐ to 100‐point VAS and improvement in functional status by the Oswestry Disability Index (ODI version 2.0) at 2 weeks and 1, 2, 3, and 6 months. All baseline variables were comparable between the 2 groups. Statistically significant reduction in both outcomes was seen in the LPRF group compared to the LA group from 2 weeks to 6 months. One hundred percent of patients in the LPRF group had a ≥20‐ point decrease in VAS and significant percentage reduction in ODI at all time intervals up to 6 months, whereas it was seen in 80% and 28% of patients in the LA group at 3 and 6 months, respectively. No complications were seen in any patients Conclusion: Pulsed radiofrequency of the DRG applied for longer duration results in long‐term pain relief and improvement in the functional quality of life in patients with chronic LRP.
- Subjects
CHRONIC pain treatment; FUNCTIONAL assessment; LIDOCAINE; LIFE skills; LOCAL anesthetics; LONGITUDINAL method; LUMBAR vertebrae; NERVE block; EPIDURAL anesthesia; QUALITY of life; SPINAL nerve roots; PAIN management; RADIO frequency therapy; RANDOMIZED controlled trials; VISUAL analog scale; TREATMENT effectiveness; BLIND experiment; TREATMENT duration; BUPIVACAINE; LUMBAR pain
- Publication
Pain Practice, 2020, Vol 20, Issue 2, p154
- ISSN
1530-7085
- Publication type
Article
- DOI
10.1111/papr.12840