Dorsal Root Ganglion Pulsed Radiofrequency Combined With Lumbar Lateral Recess Block For The Treatment Of Lumbar Spinal Stenosis

BackgroundLumbar spinal stenosis(LSS)is a kind of spinal degenerative disease,which is one of the main causes of low back pain in the elderly.The incidence of LSS increases with age.Conservative treatment of LSS is often ineffective;Surgical treatment is usually difficult to be accepted by the patients due to the large amount of trauma and complications;The epidural injection of simple drugs is often effective in a short time and the patients require to be repeated injections,which can cause some complications and side effects.In recent years,pulsed radiofrequency(PRF)has been increasingly applied in chronic pain with its advantages of non-or minimally neurodestructive characteristic,less complication and repeatability.However,There are a limited number of studies on the pulsed radiofrequency treatment for dorsal root ganglion in patients suffering from LSS.The purpose of this study is to observe the clinical efficacy of DRG-PRF combined with lumbar lateral recess block in the treatment of LSS.ObjectiveTo evaluate the clinical efficacy and safety of pulsed radiofrequency on the dorsal root ganglion combined with lumbar lateral recess block in treating patients suffering from LSS;To explore the related factors that affect the curative effect of theprocedures.MethodsForty patients who suffered from LSS treated with DRG-PRF combined with lateral recess block in Shandong Provincial Hospital from June 2014 to June 2017 were enrolled as the observation group,and forty patients who suffered from LSS treated with simple lateral recess block were selected randomly as the control group.The visual analogue scale(VAS)was observed at pre-treatment,1 week,1 month,3 months and 6 months after treatment;the outcome results were graded as excellent,good,fair or poor based on the MacNab criteria with modification.Logistic regression analysis was performed on risk factors that might affect the curative effect.Record the adverse reactions and patients who received other surgical treatment during half a year.ResultsThere were no significant differences between the two groups among age,gender and the visual analogue scale before treatment(P>0.05).VAS values decreased significantly after treatment in both groups(P<0.05).VAS values decreased significantly at 3 months and 6 months after treatment in observation group(P<0.05),combined with the control group.The excellent and good rates at 1 month and 6 months after treatment of the observation group were significantly higher than that in the control group(P<0.05).Logistic regression analysis indicated that the curative effect in the observation group was better than that in the control group.No serious complications were found in the observation group,but 2 patients in the control group were infected with spondylodiscitis.In the observation group,2 patients received spinal endoscopy and one patient underwent surgical treatment during half a year;in the control group,4 patients received surgical treatment during half a year.ConclusionsThe clinical efficacy of combination of dorsal root ganglion pulsed radiofrequency and lumbar lateral recess block treatment on lumbar spinal stenosis is better than lumbar lateral recess block alone.Efficacy is related to different therapeutic methods;Gender,age,laborer,whether to live in the countryside,disease duration,lesion segment,whether the walking distance is less than 100 meters have not showed the statistical difference to the clinical efficacy.