A study presented at the annual meeting of the Radiological Society of North America (RSNA, 26 November-1 December, Chicago, USA) has found that the majority of patients were pain free after receiving a new image-guided pulsed radiofrequency treatment for low back pain and sciatica.
Most back pain is short-term, but about 20% of people affected by acute low back pain go on to develop chronic low back pain lasting a year or more.
“The nerve root is a sensitive structure that when pinched becomes inflamed and causes pain. The body reacts with muscle constriction, which decreases the distance between vertebrae, and a vicious cycle is created,” said lead investigator Alessandro Napoli, an interventional radiologist at Sapienza University of Rome, Rome, Italy.
The single centre prospective study included 80 patients experiencing at least three months of low back pain due to a herniated disk that had not responded to conservative treatments including exercise and medication.
The patients underwent a minimally invasive interventional radiology procedure in which, with the help of CT imaging, a needle is guided to the location of the bulging disc and nerve root. A probe is then inserted through the needle tip and delivers pulsed radiofrequency energy to the area over a 10-minute period. Even without touching the disc, the pulsation serves to resolve the herniation.
“The probe delivers a gentle electrical energy, so there’s no thermal damage. The results have been extraordinary. Patients have been relieved of pain and resumed their normal activities within a day,” Napoli said.
Of the 80 patients treated, 81% were pain free one year after a single 10-minute treatment session. Six patients required a second pulsed radiofrequency session. Ninety per cent of the patients were able to avoid surgical treatment.
“Following this treatment, inflammation and pain go away. With relaxation of the muscles, the distance between the vertebrae returns,” Napoli explained.
He added that no patients experienced side effects after receiving the minimally invasive outpatient treatment.
“There is a big gap between conservative treatments for disc compression and herniation and surgical repair, which can lead to infection, bleeding and a long recovery period. Evolving technologies like this image-guided treatment may help a substantial number of patients avoid surgery,” Napoli concluded.