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Musculoskeletal Radiology

A Novel Radiofrequency Thermocoagulation Method for Treatment of Lower Back Pain: Thermal Conduction after Instillation of Saline Solution into the Nucleus Pulposus—Preliminary Results

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Pages 934-939 | Published online: 09 Jul 2009
 

Abstract

Background: Radiofrequency heating of the intervertebral disc has been proposed for the treatment of chronic low back pain using two methods: a flexible needle inserted into the annulus fibrosus achieving a full 360° penetration, or a rigid needle inserted into the nucleus pulposus. The first technique is effective on pain, but the clinical benefit of the second is uncertain.

Purpose: To evaluate a technique for radiofrequency heating of the lumbar intervertebral disc by a needle placed into the nucleus pulposus.

Material and Methods: The method was tested in 17 patients according to the criteria used in previous intradiscal radiofrequency studies. Before and after treatment, disability was assessed by the Oswestry disability score. A pain reduction of at least 50% was considered a success.

Results: Fifteen patients were responders at 1 month (88%), nine at 3 months (53%), and 12 at 6 months (70.6%). No complications were observed.

Conclusion: A new method of providing discal radiofrequency treatment for lower back pain had a substantial clinical benefit in 71% of the observed patients. A prospective study comparing this new method with placebo should be conducted to confirm these initial results.

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