Background: Chronic lumbosacral radicular pain is a common source of radiating leg pain
seen in pain management patients. These patients are frequently managed conservatively with
multiple modalities including medications, physical therapy, and epidural steroid injections.
Radiofrequency has been used to treat chronic radicular pain for over 30 years; however,
there is a paucity of literature about the safety and efficacy of repeat radiofrequency lesioning.
Objectives: To determine the safety, success rate, and duration of pain relief of repeat
pulsed radiofrequency (PRF) and continuous radiofrequency (CRF) lesioning of the dorsal root
ganglion (DRG)/ sacral segmental nerves (SN) in patients with chronic lumbosacral radicular
pain.
Study Design: Retrospective chart review
Setting: Outpatient multidisciplinary pain center
Methods: Medical record review of patients who were treated with pulsed and continuous
radiofrequency lesioning of the lumbar dorsal root ganglia and segmental nerves and who
reported initial success were evaluated for recurrence of pain and repeat radiofrequency
treatment. Responses to subsequent treatments were compared to initial treatments for
success rates, average duration of relief, and adverse neurologic side-effects.
Limitations: Retrospective chart review without a control group.
Results: Twenty-six women and 24 men were identified who received 50% pain relief or better
after PRF and CRF of the lumbar DRG/ sacral SN for lumbosacral radicular pain. The mean
age was 62 years (range, 25-86). The mean duration of relief for the 40 patients who had 2
treatments was 4.7 months (range 0-24; Se [standard error] 0.74). Twenty-eight patients had
3 treatments with an average duration of relief of 4.5 months (range 0-19 months; Se 0.74).
Twenty patients had 4 treatments with a mean duration of relief of 4.4 months (range 0.5-18;
Se 0.95) and 18 patients who had 5 or more treatments received an average duration of relief
of 4.3 months (range 0.5-18; Se 1.03). The average duration of relief and success frequency
remained constant after each subsequent radiofrequency treatment. Of the 50 total patients,
there was only 1 reported complication, specifically, transient thigh numbness which resolved
after one week.
Conclusions: Repeated pulsed and continuous radiofrequency ablation of the lumbar dorsal
root ganglion/segmental nerve shows promise to be a safe and effective long-term palliative
management for lumbosacral radicular pain in some patients.
Key words: Pulsed radiofrequency lesioning, dorsal root ganglion, segmental nerve,
continuous radiofrquency elsioning, chronic lumbosacral radicular pain
Retrospective Review of the Efficacy and Safety of
Repeated Pulsed and Continuous Radiofrequency
Lesioning of the Dorsal Root Ganglion/Segmental
Nerve for Lumbar Radicular Pain