Xinying Zhou, n/a: No financial relationships to disclose
Introduction: Lumbar intervertebral disc derived painful stimulation is conducted by lumbar sinuvertebral nerve (LSVN). Neurolysis of LSVN may be a efficient way to treat discogenic low back pain (DLBP). Our previous study has precisely described the anatomic distribution of LSVN. LSVN blocks (LSVNB) and radiofrequency ablation (LSVN-RFA) was performed to DLBP patients.
Objectives: This study was aimed at evaluating the effectiveness and safety of those 2 types of surgery targeting LSVN on treating DLBP.
Methods: This study was a prospective cohort study. DLBP patients received LSVNB or LSVN-RFA were incorporated in this cohort. Total follow up time was 3 years. Lumbar visual analogue scale (VAS) was used to evaluate the degree of low back pain. Oswestry disability index (ODI) was used to evaluate the lumbar function. VAS and ODI were respectively evaluated at 1 day before the operation and 1 day, 3 months, 6 months, 1 year, 2 years, 3 years after the operation.
Results: For LSVNB, VAS was significantly reduced at 1 day, 3 months but no more than 6 months after the operation (pre vs 6m, 4.94±1.66, 2.50±1.46, p＜0.01), ODI was significantly improved within 3 months after the operation (pre vs 3m, 32.59±21.56, 16.84±13.51, p＜0.01). For LSVN-RFA, VAS was significantly reduced at 3 years after the operation (pre vs 3y, 5.14±1.26, 2.20±1.12, p＜0.01), ODI was significantly improved at 3 years after the operation (pre vs 3y, 36.45±16.92, 18.32±16.27, p＜0.01). Both VAS and ODI had no significant differences within 3 months after the operation between LSVNB and LSVN-RFA (p=0.18). LSVN-RFA’s VAS reduction and ODI improvement were significantly better than those of LSVNB in 6 months to 3 years after the operation (p＜0.05). Adverse events were neither reported in LSVNB nor LSVN-RFA in perioperation period and follow-up period.
Conclusion: Short-term (within 6 montns) effect of LSVNB is good but long-term (6 months to 3 years) effect is poor. Long-term (1 month to 3 years) effect of LSVN-RFA is good and steady. LSVN-RFA provides better pain relief and more lumbar function improvement than LSVNB. Both LSVNB and LSVN-RFA are safe operations for treating DLBP when surgeon’s knowledge of anatomy of LSVN is accurate. LSVN-RFA is a better choice than LSVNB for longer and better effectiveness when targeting LSVN to treat DLBP.
