Efficacy of laser nucleoplasty and radiofrequency neuromodulation in the treatment of discogenic lumbar radiculopathy

Abstract

Back and lower limb pain interferes with patients’ daily lives and ultimately reduces their quality of life. Many interventional treatments have been proposed to reduce and prevent the development of chronic pain syndrome.The aim of the study. To evaluate the effectiveness of the simultaneous use of laser nucleoplasty and radiofrequency neuromodulation of radicular nerves and ganglia in the treatment of discogenic lumbar radiculopathy.Materials and methods. The study included 20 patients; the mean age was 39 ± 9.1 years. All patients underwent laser nucleoplasty of the LIV/LV intervertebral disc and radiofrequency neuromodulation of the radicular nerve in the foraminal space of the level of interest and localization of pain. An assessment of changes in pain intensity and quality of life was carried out according to scales in the preand postoperative period and a control magnetic resonance imaging (MRI) study at the time of discharge, 3 months of observation, with an assessment of the volumetric indicators of the intervertebral disc.Results. Patients showed a decrease in pain intensity according to the Visual Analogue Scale and an improvement in quality of life assessed by the ODI (Oswestry Disability Index) and SF-36 (Short Form 36) questionnaires. According to MRI studies, volumetric indicators increased after surgery and subsequently decreased by the 3rd month of observation.Conclusion. The study demonstrates the possibility of using several interventional treatment methods simultaneously with an impact on various morphological substrates that cause the formation of pain syndrome. It is shown that a decrease in the intensity of pain syndrome correlates with an increase in the volumetric indicators of the intervertebral disc according to MRI data immediately after surgery, with a subsequent decrease by 3 months of observation. Simultaneous use of laser nucleoplasty and radiofrequency neuromodulation is justified in the treatment of radiculopathy, allowing reducing the intensity of pain syndrome and increasing the volumetric indicators of the intervertebral disc, which is a sign that increases the shock-absorbing properties of the intervertebral disc.

Keywords

• laser vaporization
• lumbar spine
• radiofrequency ablation
• neuromodulation
• discogenic radiculopathy
• pain syndrome
• clinical efficacy