Pulsed Radiofrequency + Steroids Best for Sciatica From Herniated Disc

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Outcomes better with pulsed radiofrequency + transforaminal epidural steroid injection than injection alone in terms of leg pain severity, disability over one year after treatment.

HealthDay News — A combination of pulsed radiofrequency (PRF) and transforaminal epidural steroid injection (TFESI) treatment is better than TFESI alone for pain relief and disability improvement among patients with sciatica caused by lumbar disc herniation, according to a study published online March 28 in Radiology.

Alessandro Napoli, MD, PhD, from the Policlinico Umberto I–Sapienza University of Rome, and colleagues randomly assigned patients with sciatica due to lumbar disc herniation lasting 12 weeks or longer that did not respond to conservative treatment to undergo one computed tomography-guided treatment with combined PRF and TFESI or TFESI alone (174 and 177 participants, respectively). At weeks 1 and 52 after treatment, leg-pain severity was measured with the numeric rating scale (NRS).

NRS at baseline was 8.1±1.1 in the PRF and TFESI group and 7.9±1.1 in the TFESI group. The researchers found that at week 1, NRS was 3.2±0.2 in the PRF and TFESI group and 5.4±0.2 in the TFESI group, respectively, compared with 1.0 ± 0.2 and 3.9±0.2, respectively, at week 52 (average treatment effect, 2.3 and 3.0 at weeks 1 and 52, respectively). The average treatment effect at week 52 was 11.0 for the Oswestry Disability Index and 2.9 for the Roland-Morris Disability Questionnaire score, favoring the combined group.

“Participants who underwent PRF combined with TFESI for persistent sciatica caused by lumbar disc herniation experienced better clinical outcomes in terms of pain relief and functional recovery over the first year after treatment as compared with those who underwent TFESI alone,” the authors write.

One author disclosed financial ties to the medical device industry; a second author disclosed ties to the publishing industry.

Abstract/Full Text

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