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Olav Rohof MD, PhD, FIPP
Pain Practice. Article first published online: 19 OCT 2011

Abstract:  The development of diagnostic criteria and the use of provocative discography allow identifying the degenerative disc as causative structure for chronic low-back pain. Unfortunately, none of the available interventional treatment options have been demonstrated to be effective over a prolonged period of time for a considerable number of patients.

Pathophysiological studies indicate sprouting of sensory nerves and inflammatory processes as underlying pain mechanisms.

Pulsed radiofrequency (PRF) treatment in small and larger joints was described to reduce pain and improve healing by stimulating the immunology. Earlier findings of PRF applied in the disc annulus were promising. It is assumed that PRF applied in the nucleus would change the conductivity of nerve endings and provide a clinically relevant pain reduction. The application of the electric field of PRF in the disc may also activate the immune system, thus reducing the inflammation process of chronic pain.

Pulsed radiofrequency in the nucleus was studied in 76 patients with discogenic pain confirmed by magnetic resonance imaging and provocative discography. At 3-month follow-up, 38% of the patients had > 50% pain reduction, at 12 month the effect is maintained in 29%. In patients with unsatisfactory pain relief 3 months after the intervention, secondary pain sources may have been revealed. The latter were treated accordingly. Of all patients, 56% had > 50% pain reduction 1 year after first treatment.

Our findings suggest that PRF in the nucleus may be considered for patients with proven discogenic pain. A randomized controlled trial to confirm our findings is justified.▪

I got dumber. Help me understand how 38% had >50% relief at 3 months, then 56% had >50% at one year. It looks like someone is writing to show a difference when none exists.
My favorite part is when he says pulsed stimulates "the immunology". Utter nonsense that sounds like internet scam.


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its all in his wording, and it is not a well done study.

the additional 18% are from the 62% that did not get satisfactory relief from the study had other procedures done. i.e. epidurals, neuromodulators, increase opioids, spinal fusion, cordectomy, frontal lobotomy, etc.

essentially, he is assigning credit of benefit towards his procedure that was due to other interventions.
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