INTERVENTIONAL COMBINED RADIOFREQUENCY METHOD IN THE TREATMENT OF CHRONIC LUMBOSACRAL RADICULAR PAIN ASSOCIATED WITH...

Intervertebral disc degeneration often is a cause of low back pain (LBP) and radicular pain even without severe compression of the nerve root by hernial material. Thermodiscoplasty, or intradiscal electrothermal therapy (IDET) is used for minimally invasive treatment of discogenic pain. Pulsed radiofrequency (PRF) of the dorsal root ganglion (DRG) is used as an interventional method for radicular pain elimination. For the first time we have proposed the simultaneous combined use of these techniques. Our research's aim - to study the dynamics of pain syndrome and disability in patients undergone simultaneous combined treatment with the IDET and PRF DRG for pain associated with moderate disc herniation without spinal root severe compression, which confirmed motor and sensitive deficit absence. A retrospective analysis of 22 patients treated at the Neurospine clinic (Kyiv) from 2019 to 2020 was carried out. All patients had degenerative-dystrophic disease of the intervertebral discs L4-L5 and L5-S1 with therapeutically resistant radicular pain. The standard examination included two-plane spondylography and magnetic resonance imaging, as well as an assessment of neurological status. The discogenic origin of pain is confirmed by provocative contrasting discography. The interest of the corresponding spinal root was confirmed by performing selective radicular blockade.The treatment results were assessed using the Numerical rating scale (NRS) and the Oswestry disability index (ODI); statistical processing was carried out using Microsoft Excel and Statistica-10 program tools. There were no complications detected. All patients noted a significant reduction in pain and decrease of disability: VAS (Me) before treatment = 7.77±1.02, ODI (Ме) before treatment = 70.45±7.85; VAS (Me) immediately after surgery = 2.18±1.13. This trend persisted for six months: VAS (Me) 6 months after surgery = 2.0±0.75, ODI (Me) 6 months after surgery = 30.45±9.98. The simultaneous combined use of IDET and PRF DRG is an effective and safe treatment for therapeutically resistant chronic lumbosacral radicular pain associated with moderate disc herniation.