High-voltage pulsed radiofrequency of dorsal root ganglion helps relieve pain

Delivering high-voltage pulsed radiofrequency (PRF) of dorsal root ganglion via a multifunctional electrode yields significant pain relief and may prove valuable in the treatment of chronic lumbosacral radicular pain with neuropathic features, according to a recent study.

The study included 41 patients randomized to receive two cycles of 240 seconds high-voltage PRF followed by the injection of local anaesthetics, hyaluronidase and betamethasone (PRF-EA; n=21) or to undergo sham stimulation followed by adhesiolysis (EA; n=20). Treatment was delivered at the affected lumbosacral roots, with patients, treating physicians and assessors blinded to intervention.

At follow-up, the intervention produced a significant reduction in radiating pain compared with sham stimulation. The respective mean Numeric Rating Scale scores decreased by –3.43 vs –1.75 after 1 month (p=0.031) and by –3.34 vs –0.80 after 6 months (p=0.005).

Furthermore, significantly more patients in the PRF-EA vs EA-only group achieved a pain reduction of ≥50 percent in the first month of follow-up (57 percent vs 25 percent; odds ratio [OR], 4.00, 95 percent confidence interval [CI], 1.057–15.138; p=0.037).

At 6 months, only 10 percent of patients who underwent EA achieved significant pain relief as opposed to 48 percent of those who received radiofrequency and adhesiolysis (OR, 8.12, 95 percent CI, 1.505–44.491; p=0.008).

These findings, if confirmed, represent a significant step forward in the treatment of challenging neuropathic pain syndromes, according to the researchers. This underscores a need for randomized controlled trials testing the long-term effects of PRF in order to evaluate the contribution of the technique in pain management.