Eficacia de la Radiofrecuencia Pulsada en el Tratamiento del Síndrome de Dolor Regional Complejo de Tipo 1 en las Extremidades Inferiores: Comparación con el Bloqueo Simpático Lumbar

Tiago Freitas Da Silva; Oswaldo R. Marqués Neto; Irueña Kessler; Richard Sugai

doi:10.47924/neurotarget2011298

Authors

Tiago Freitas Da Silva Department of Neurosurgery, Hospital Universitario de Brasilia (HUB), Brasilia, Brazil.
Oswaldo R. Marqués Neto Department of Neurosurgery, Hospital Universitario de Brasilia (HUB), Brasilia, Brazil.
Irueña Kessler Department of Neurosurgery, Hospital Universitario de Brasilia (HUB), Brasilia, Brazil.
Richard Sugai Department of Neurosurgery, Hospital Universitario de Brasilia (HUB), Brasilia, Brazil.

DOI:

https://doi.org/10.47924/neurotarget2011298

Keywords:

complex regional pain syndrome, CRPS, type 1, lower extremities, treatment, pulsed radiofrequency, lumbar sympathetic block

Abstract

Objective: Complex regional pain syndrome (CRPS) type 1 is a neuropathic pain syndrome usually difficult to treat. The purpose of this study is to compare two treatment options (pulsed radiofrequency and lumbar sympathetic block) evaluating the effectiveness of each in the control of the different characteristics of this condition and its effect on quality of life of patients.
Patients and methods: 40 patients with complex regional pain syndrome type 1 in the lower limbs were randomized into two groups: pulsed radiofrequency and lumbar sympathetic block (at the level of L2, L3 and L5). Patients were prospectively evaluated using the VAS (Visual Analog Scale of Pain), the Neuropathic Pain Scale (Galer y Jensen) and the RAND SF-36 scale during follow-up of 1 and 7 days and 2, 4, 6 and 12 months.
Results: We found statistically similar reductions in both groups from baseline after the procedure, according to the different pain scales. However, there was a significant difference only for the attribute “hot pain”, which remained decreased over the months in the group treated with radiofrequency but not in the other group.
Conclusions: The pulsed radiofrequency emerges as a non- ablative technique, with long-term results similar to those obtained with lumbar sympathetic block for the treatment of complex regional pain syndrome type 1 in the lower extremities.

Metrics

Metrics Loading ...

References

Burchiel KJ, editor. Surgical management of pain. New York: Thieme; 2002.

Ramanavarapu V, Simopoulos TT. Pulsed radiofrequency of lumbar dorsal root ganglia for chronic post-amputation stump pain. Pain Physician. 2008;11(4):561-6.

Erdine S, Yucel A, Cimen A, Aydin S, Sav A, Bilir A. Effects of pulsed versus conventional radiofrequency current on rabbit dorsal root ganglion morphology. Eur J Pain. 2005;9(3):251-6.

Van Zundert J, de Louw AJ, Joosten EA, Kessels AG, Honig W, Dederen PJ, et al. Pulsed and continuous radiofrequency current adjacent to the cervical dorsal root ganglion of the rat induces late cellular activity in the dorsal horn. Anesthesiology. 2005;102(1):125-31.

Chao SC, Lee HT, Kao TH, Yang MY, Tsuei YS, Shen CC, et al. Percutaneous pulsed radiofrequency in the treatment of cervical and lumbar radicular pain. Surg Neurol. 2008;70(1):59-65; discussion 65.

Hussain AM, Afshan G. Use of pulsed radiofrequency in failed back surgery syndrome. J Coll Physicians Surg Pak. 2007;17(6):353-5.

Rozen D, Parvez U. Pulsed radiofrequency of lumbar nerve roots for treatment of chronic inguinal herniorraphy pain. Pain Physician. 2006;9(2):153-6.

Bruehl S, Harden RN, Galer BS, Saltz S, Bertram M, Backonja M, et al. External validation of IASP diagnostic criteria for Complex Regional Pain Syndrome and proposed research diagnostic criteria. International Association for the Study of Pain. Pain. 1999;81(1-2):147-54.

Galer BS, Jensen MP. Development and preliminary validation of a pain measure specific to neuropathic pain: the Neuropathic Pain Scale. Neurology. 1997;48(2):332-8.

Benzon HT. The neuropathic pain scales. Reg Anesth Pain Med. 2005;30(5):417-21.

Van Eijs F, Stanton-Hicks M, Van Zundert J, Faber CG, Lubenow TR, Mekhail N, et al. Evidence-based interventional pain medicine according to clinical diagnoses. 16. Complex regional pain syndrome. Pain Pract. 2011;11(1):70-87.

Stanton-Hicks MD, Burton AW, Bruehl SP, Carr DB, Harden RN, Hassenbusch SJ, et al. An updated interdisciplinary clinical pathway for CRPS: report of an expert panel. Pain Pract. 2002;2(1):1-16.