Researchers say that their CT-guided pulsed radiotherapy technique could help to alleviate chronic low back pain.
A herniated disk, which is also referred to as a "slipped" or "ruptured" disk, occurs when the disks between the spine's vertebrae protrude, or "herniate." This can pinch the spinal nerves and cause pain, particularly in the lower back.
"The nerve root is a sensitive structure that when pinched becomes inflamed and causes pain," says lead study investigator Dr. Alessandro Napoli, of the Sapienza University of Rome in Italy.
"The body reacts with muscle constriction, which decreases the distance between vertebrae, and a vicious cycle is created."
For 90 percent of people with back pain because of a herniated disk, symptoms will pass within 6 weeks. But for the remaining 10 percent, it is unlikely that current medical treatments alone will alleviate pain. In severe cases, surgery to ease nerve pressure is the best option.
"There's a big gap," says Dr. Napoli, "between conservative treatments for disc compression and herniation and surgical repair, which can lead to infection, bleeding, and a long recovery period."
But he and his colleagues may have discovered an alternative treatment option that is significantly less invasive than surgery.
The researchers recently presented their new results at the Radiological Society of North America annual meeting, held in Chicago, IL.
The new treatment involves using computed tomography (CT) imaging to help guide a needle to the patient's herniated disk and nerve root. Next, a probe is inserted into the needle. For 10 minutes, the probe delivers pulses of electrical energy to the affected area.
"Following this treatment, inflammation and pain go away," explains Dr. Napoli. "With relaxation of the muscles, the distance between the vertebrae returns."
Over the course of 3 years, the researchers tested the technique on 80 people with chronic low back pain caused by a herniated disk. Patients had been experiencing pain for at least 3 months, and they failed to respond to medication or exercise.
After having just one session of the CT-guided pulsed radiofrequency procedure, 90 percent of the participants were pain-free within a month, and 81 percent of these subjects remained free of pain after 1 year.
"The results have been extraordinary. Patients have been relieved of pain and resumed their normal activities within a day."
Dr. Alessandro Napoli
The researchers note that six of the participants required a second treatment, and these were considered "partial responders."
Importantly, 90 percent of the subjects were able to avoid surgery, the scientists report, and none of the subjects experienced side effects.
Based on their findings, Dr. Napoli and his team believe that their CT-guided pulsed radiofrequency technique could offer a highly effective, minimally invasive treatment option for individuals with low back pain.
"Evolving technologies like this image-guided treatment may help a substantial number of patients avoid surgery," Dr. Napoli concludes.