Comparison of Pain and Quality-of-Life Outcomes Following Bipolar Versus Monopolar Pulsed Radiofrequency Treatment...

Pulsed radiofrequency of the dorsal root ganglion (DRG) is an established treatment for chronic lumbosacral radicular pain, yet comparative evidence on monopolar versus bipolar configurations, particularly regarding quality-of-life outcomes, remains limited. This study aims to compare the analgesic and quality-of-life effects of bipolar versus monopolar pulsed radiofrequency of the lumbosacral DRG.

We conducted a mixed retrospective and prospective observational review of 143 patients with chronic radicular pain due to lumbosacral disc herniation who underwent DRG pulsed radiofrequency in 2022 and 2023. Patients received either bipolar (n = 79) or monopolar pulsed radiofrequency (n = 64). Pain intensity was recorded using the Numeric Rating Scale at baseline and at 1st, 2nd, and 6th month post-procedure. Quality of life was assessed with Short Form-36 (SF-36) at baseline and 6 months. Any potential complications were recorded to evaluate the safety of procedures.

Baseline demographic and clinical characteristics were comparable between groups. All patients exhibited significant reductions in pain scores over time (p < 0.001). However, bipolar pulsed radiofrequency produced significantly greater pain relief at all follow-up points, with mean pain scores at 6 months of 2.32 versus 4.78 in the monopolar group (p < 0.001). At 6 months, bipolar pulsed radiofrequency also resulted in significantly higher SF-36 scores across all eight domains and in total score (583.61 vs. 425.29, p < 0.001).

Bipolar pulsed radiofrequency of the lumbosacral DRG was associated with greater improvements in pain and quality of life compared with the monopolar modality in patients with chronic lumbosacral radicular pain. These show the potential of bipolar PRF to enhance clinical and functional outcomes in this population.