Lumbar Dorsal Root Ganglion Block as a Prognostic Tool Before Pulsed Radiofrequency: A Randomized, Prospective, and Comparative Study on Cost-Effectiveness

World Neurosurg. 2018 Apr:112:e157-e164. doi: 10.1016/j.wneu.2017.12.183. Epub 2018 Jan 6.

Abstract

Objectives: In the study, we discuss the predictive value and cost-effectiveness of dorsal root ganglion (DRG) blocks before using dorsal root ganglion pulsed radiofrequency (DRG-PRF) in the treatment of low back pain.

Methods: The study comprised 60 patients with low back pain who were randomly assigned into 2 groups. Patients in group 1 were screened using DRG block before DRG-PRF treatment for responders. Patients in group 2 underwent DRG-PRF treatment without DRG block. Successful outcome was defined as patient satisfaction, improvement in numerical rating scale, and medication use reduction.

Results: In group 1 (n = 30), 24 patients demonstrated good response to DRG block, and 20 patients had successful outcome at 6 months after DRG-PRF therapy. In group 2 (n = 30), 25 of the patients had successful outcome at 6 months after DRG-PRF therapy. The mean medical costs were NT$ 19,245 and NT$ 16,375 for each successful case in groups 1 and 2, respectively.

Conclusions: In this comparative cost-effectiveness study, the application of diagnostic DRG blocks before DRG-PRF did not have a significant impact on patient satisfaction, pain index score, or pain medication reduction. Furthermore, the application of diagnostic DRG blocks resulted in overall greater medical costs. These findings suggest that DRG-PRF without screening by DRG block is more cost-effective and less invasive.

Keywords: Cost-effectiveness; Dorsal root ganglion; Low back pain; Lumbar; Prognostic; Pulse radiofrequency; Randomize.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cost-Benefit Analysis*
  • Female
  • Ganglia, Spinal
  • Humans
  • Low Back Pain / diagnosis*
  • Low Back Pain / therapy*
  • Male
  • Middle Aged
  • Nerve Block / economics*
  • Nerve Block / methods
  • Predictive Value of Tests
  • Pulsed Radiofrequency Treatment / economics*
  • Pulsed Radiofrequency Treatment / methods