Effectiveness of High-Voltage PRF for Chronic Lumbosacral Radicular Pain

NCT ID: NCT07303309

Last Updated: 2025-12-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

22 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-07

Study Completion Date

2025-04-29

Brief Summary

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This randomized controlled trial compared high-voltage (60 V) and low-voltage (45 V) pulsed radiofrequency (PRF) for treating chronic lumbosacral radicular pain in adult patients. The study evaluated differences in pain reduction (using the Visual Analogue Scale \[VAS\] and Numeric Rating Scale \[NRS-11\]), functional ability (using Oswestry Disability Index scores), serum Interleukin-6 levels, and overall safety. All participants received fluoroscopy-guided PRF at 42°C for three 120-second cycles and were followed for approximately 6 weeks.

Detailed Description

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Consecutive patients who met the inclusion and exclusion criteria were enrolled and randomized into two groups: the intervention group (high-voltage PRF, 60 V) and the control group (low-voltage PRF, 45 V). The sample size was calculated using the Neyman-Pearson approach with a superiority hypothesis, assuming that the intervention group would achieve greater pain reduction than the control group. Accounting for an estimated 20% dropout rate, 11 participants were required per group. Patients who voluntarily withdrew from the study were excluded from analysis, whereas patients who discontinued the intervention due to adverse effects during or after the procedure were included in the analysis and reported.

Conditions

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Lumbosacral Radicular Pain Chronic Radicular Back Pain

Keywords

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pain measurement high-voltage pulsed radiofrequency chronic lumbosacral radicular pain visual analogue pain scale

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Standard/Low-voltage pulsed radiofrequency (45V) was compared with high-voltage pulsed radiofrequency (60 V)
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Standard/Low-Voltage PRF at 45 V

Pulsed Radiofrequency set the voltage at 45 V.

Group Type ACTIVE_COMPARATOR

Pulsed Radiofrequency

Intervention Type DEVICE

A specialist performed fluoroscopy-guided monopolar Pulsed Radiofrequency (PRF) on a prone patient using a 22-gauge cannula (Cosman CC, CR type, 10 cm with a 10 mm active tip). Sensory stimulation prior to the procedure was applied at 200 Ohm, 50 Hz (threshold: 0.3 - 0.5 V), and motor stimulation at 2 Hz (threshold: 0.9 - 1.5 V). PRF was applied at a maximum temperature of 42 centigrade, with a frequency of 2 Hz, pulse width of 20 milliseconds, and a duration of 120 seconds per cycle for three cycles. An operating room nurse set the voltage at 45 V or 60 V.

Post-operative Analgesia

Intervention Type DRUG

Post-procedure analgesia in both groups was provided via IV fentanyl 0.5-1 µg/kg, administered as needed for patients reporting an NRS score greater than 4. This intervention was not a primary focus of the study.

High-Voltage PRF at 60 V

Pulsed Radiofrequency set the voltage at 60 V.

Group Type EXPERIMENTAL

Pulsed Radiofrequency

Intervention Type DEVICE

A specialist performed fluoroscopy-guided monopolar Pulsed Radiofrequency (PRF) on a prone patient using a 22-gauge cannula (Cosman CC, CR type, 10 cm with a 10 mm active tip). Sensory stimulation prior to the procedure was applied at 200 Ohm, 50 Hz (threshold: 0.3 - 0.5 V), and motor stimulation at 2 Hz (threshold: 0.9 - 1.5 V). PRF was applied at a maximum temperature of 42 centigrade, with a frequency of 2 Hz, pulse width of 20 milliseconds, and a duration of 120 seconds per cycle for three cycles. An operating room nurse set the voltage at 45 V or 60 V.

Post-operative Analgesia

Intervention Type DRUG

Post-procedure analgesia in both groups was provided via IV fentanyl 0.5-1 µg/kg, administered as needed for patients reporting an NRS score greater than 4. This intervention was not a primary focus of the study.

Interventions

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Pulsed Radiofrequency

A specialist performed fluoroscopy-guided monopolar Pulsed Radiofrequency (PRF) on a prone patient using a 22-gauge cannula (Cosman CC, CR type, 10 cm with a 10 mm active tip). Sensory stimulation prior to the procedure was applied at 200 Ohm, 50 Hz (threshold: 0.3 - 0.5 V), and motor stimulation at 2 Hz (threshold: 0.9 - 1.5 V). PRF was applied at a maximum temperature of 42 centigrade, with a frequency of 2 Hz, pulse width of 20 milliseconds, and a duration of 120 seconds per cycle for three cycles. An operating room nurse set the voltage at 45 V or 60 V.

Intervention Type DEVICE

Post-operative Analgesia

Post-procedure analgesia in both groups was provided via IV fentanyl 0.5-1 µg/kg, administered as needed for patients reporting an NRS score greater than 4. This intervention was not a primary focus of the study.

Intervention Type DRUG

Other Intervention Names

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PRF Rescue Analgesia Post-operative opioid

Eligibility Criteria

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Inclusion Criteria

* Adults aged ≥ 18 years old
* Numeric Rating Scale (NRS-11) ≥ 4 at screening
* Clinical diagnosis of lumbosacral radicular pain with symptom duration ≥ 12 weeks
* Insufficient response to conservative therapy, including but not limited to pharmacotherapy and/or physiotherapy

Exclusion Criteria

* Known hypersensitivity or allergy to medication required during the study (e.g., steroid, contrast media)
* Coagulopathy, systemic infection, localized infection at needle-entry site, lumbar fracture, myelopathy, or severe organ dysfunction (e.g., renal failure, heart failure, severe respiratory diseases)
* Comorbidities that compromise valid pain assessment (e.g., post-stroke, central neuropathy, malignancy)
* Previous neurological deficits
* Pregnancy
* Refusal of participation in the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Faculty of Medicine, Gadjah Mada University

UNKNOWN

Sponsor Role collaborator

Sardjito General Hospital, Yogyakarta, Indonesia

UNKNOWN

Sponsor Role collaborator

Hasanuddin University

OTHER

Sponsor Role lead

Responsible Party

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dr. Farhan Ali Rahman, Sp. An-T.I., F.I.P.

Head of Education and Training Division RSUP Dr. Sardjito/Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Farhan A Rahman, MD

Role: PRINCIPAL_INVESTIGATOR

RSUP Dr. Sardjito/Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada

Nur S Wirawan, MD

Role: STUDY_DIRECTOR

Department of Anesthesiology, Intensive Care, and Pain Management Hasanuddin University

Muhammad R Ahmad, MD

Role: STUDY_DIRECTOR

Department of Anesthesiology, Intensive Care, and Pain Management Hasanuddin University

Locations

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RSI Sultan Agung Islamic Teaching Hospital

Semarang, Central Java, Indonesia

Site Status

Countries

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Indonesia

References

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Deyo RA, Mirza SK. CLINICAL PRACTICE. Herniated Lumbar Intervertebral Disk. N Engl J Med. 2016 May 5;374(18):1763-72. doi: 10.1056/NEJMcp1512658. No abstract available.

Reference Type BACKGROUND
PMID: 27144851 (View on PubMed)

Jang JN, Park S, Park JH, Song Y, Kim YU, Kim DS, Sohn JE, Park S. Output Current and Efficacy of Pulsed Radiofrequency of the Lumbar Dorsal Root Ganglion in Patients With Lumbar Radiculopathy: A Prospective, Double-blind, Randomized Pilot Study. Pain Physician. 2023 Nov;26(7):E797-E804.

Reference Type BACKGROUND
PMID: 37976483 (View on PubMed)

Erken B, Edipoglu IS. Efficacy of High-Voltage Pulsed Radiofrequency of the Dorsal Root Ganglion for Treatment of Chronic Lumbosacral Radicular Pain: A Randomized Clinical Trial. Neuromodulation. 2024 Jan;27(1):135-140. doi: 10.1016/j.neurom.2022.10.056. Epub 2022 Dec 1.

Reference Type BACKGROUND
PMID: 36463027 (View on PubMed)

Other Identifiers

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28/KEPK-RSISA/I/2025

Identifier Type: -

Identifier Source: org_study_id