Long-term Inhibition of Soleus H-reflex with Epidural Adhesiolysis and Pulsed Radiofrequency in Lumbosacral Neuropathic Pain.
Adult
Aged
Epidural Space
Female
Follow-Up Studies
Ganglia, Spinal
/ physiopathology
Humans
Italy
Lumbosacral Region
Male
Middle Aged
Muscle, Skeletal
/ innervation
Neural Inhibition
/ physiology
Neuralgia
/ physiopathology
Pain Management
/ methods
Pulsed Radiofrequency Treatment
/ methods
Reflex
/ physiology
Tissue Adhesions
/ pathology
Treatment Outcome
H/M ratio
numeric rating scale
pulsed radiofrequency
radiculopathy
sural nerve action potential
Journal
Pain practice : the official journal of World Institute of Pain
ISSN: 1533-2500
Titre abrégé: Pain Pract
Pays: United States
ID NLM: 101130835
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
01
06
2020
revised:
01
09
2020
accepted:
11
09
2020
pubmed:
25
9
2020
medline:
31
7
2021
entrez:
24
9
2020
Statut:
ppublish
Résumé
Scientific data about neurophysiological changes subsequent to pulsed radiofrequency (PRF) are still lacking. The goal of this study was to evaluate sural nerve conduction and Hoffmann reflex (H-reflex) in soleus muscle following adhesiolysis and PRF in patients with unilateral chronic lumbosacral L5-S1 neuropathic radiating pain. Seventeen patients received two cycles of 240 seconds high-voltage PRF and epidural adhesiolysis. Sural nerve action potential (SNAP) and the ratio of maximum H-reflex to maximum M response (H/M ratio) as well as pain scores were collected in both lower limbs before, immediately following, and 1 month after the treatment. At follow-up, a significant reduction in numeric rating scale (NRS) and Douleur Neuropathique 4 Questions (DN4) scores was observed in 53% of patients reporting pain improvement of ≥ 30% over baseline. The H/M ratio was decreased in the affected limb following PRF (P = 0.01) and 1 month after the treatment (P = 0.04). A direct correlation was observed between H/M ratio variation and NRS score at follow-up in the treated limb (P = 0.04). No significant difference in sural nerve latency, amplitude, and velocity was detected between affected and normal side after treatment and at follow-up. Epidural adhesiolysis and PRF of the dorsal root ganglion seem to significantly affect spinal reflexes in patients with lumbosacral neuropathic radiating pain.
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
277-284Informations de copyright
© 2020 World Institute of Pain.
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