RESUMO
BACKGROUND: The effect of adding alpha lipoic acid (ALA) to pulsed radiofrequency (PRF) for treatment of lumbar-sacral pain was evaluated. OBJECTIVE: to evaluate the effect of using ALA as an adjuvant therapy with PRF for treatment of chronic lumbosacral radicular pain caused by herniated disc. METHODS: One hundred twenty patients with lumbo-sacral radicular pain allocated into 2 groups. Group I: treated with PRF at 42°C for 120âseconds. Group II: treated as in group I, plus oral ALA 600âmg (Thiotacid 600âmg, EVA PHARMA, Egypt) three times per day (1800âmg/day) for 3âweeks then 600âmg once daily for 2âweeks. The lumbo-sacral radicular pain evaluated using the numerical rating pain score and Oswestry Disability Index. RESULTS: Success rate was significantly higher in group II at 3 and 6âmonths after intervention. The median values of the numerical rating pain score and the Oswestry Disability Index were significantly lower in group II with no significant difference in Epworth Sleepiness Scale. No major complications were reported in both groups. CONCLUSION: The current study supports the use of ALA with PRF on the dorsal root ganglion for treating lumbosacral radicular pain.
Assuntos
Antioxidantes/uso terapêutico , Dor Crônica/terapia , Dor Lombar/terapia , Tratamento por Radiofrequência Pulsada/métodos , Radiculopatia/terapia , Ácido Tióctico/uso terapêutico , Quimioterapia Adjuvante , Dor Crônica/etiologia , Humanos , Deslocamento do Disco Intervertebral/complicações , Dor Lombar/etiologia , Manejo da Dor/métodos , Estudos Prospectivos , Radiculopatia/etiologia , Resultado do TratamentoRESUMO
BACKGROUND: Recurrent trigeminal neuralgia (RTN) is a common clinical problem and pain recurs in many patients after microvascular decompression (MVD). We evaluated the effect of adding pulsed radiofrequency to radiofrequency thermocoagulation at 60°C compared to radiofrequency thermocoagulation at 70°C alone in the treatment of recurrent trigeminal neuralgia after microvascular decompression. METHODS: 40 patients with recurrent trigeminal neuralgia after microvascular decompression were randomly divided into two equal groups. Group A: received prolonged duration of pulsed radiofrequency followed by less destructive thermocoagulation, while group B: received sole thermocoagulation. Then patients followed up for 2 years to evaluate the success rate by the Barrow Neurological Institute Pain Intensity (BNI) Scale, complications, and the need to medical treatment. RESULTS: The success rate was 100% in both groups at discharge (BNI < III). It was 83.3% and 78.7% after 6 months, 77.8% and 68.4% after 12 month, 72.2% and 68.4% after 18 months and 66.7% and 63.1% after 24 months in group A and B, respectively (p > .05). In group A 88.9% of patients stopped tegretol treatment after the procedure compared to 84.2% in group B (p = .32). 88.9% compared to 89.5% % in group A and B, respectively, did not use tricyclic antidepressant (p = .61). The overall complications in group A was 5.61%, while it was 36.8% in group B (p = .025). CONCLUSION: Combined pulsed and thermal radiofrequency can significantly reduce the incidence of the side effects/complications with similar success rate than using thermal radiofrequency alone in treatment of recurrent trigeminal neuralgia after microvascular decompression.