REVISTA

Un estudio prospectivo, aleatorizado, multicéntrico, abierto ensayo clínico que compara la biacuplastia intradiscal al tratamiento médico convencional

Valoración Valoración: 4 Estrellas

Descripción: La biacuplastia intradiscal aplicada por medio de dos agujas refrigeradas parecen aportar analgesia en dolor discogénico lumbar superior al tratamiento convencional

TITULO FUENTE ORIGINAL:

A Prospective, Randomized, Multi-Center, Open-Label Clinical Trial Comparing Intradiscal Biacuplasty to Conventional Medical Management for Discogenic Lumbar Back Pain.

AUTORES:

Desai MJ, Kapural L, Petersohn JD, Vallejo R, Menzies R, Creamer M, Gofeld M

REVISTA ABREV.:

Spine (Phila Pa 1976).

AÑO:

2015

FECHA DE PUBLICACIÓN:

18/12/2015

RESUMEN ORIGINAL:

Abstract
STUDY DESIGN:
This study was a prospective, randomized, crossover, multicenter trial for the evaluation of comparative effectiveness of intradiscal biacuplasty (IDB) versus conventional medical management (CMM) in the treatment of lumbar discogenic pain.
OBJECTIVE:
The objective was to demonstrate the superiority of IDB over CMM in the treatment of discogenic pain...
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Abstract
STUDY DESIGN:
This study was a prospective, randomized, crossover, multicenter trial for the evaluation of comparative effectiveness of intradiscal biacuplasty (IDB) versus conventional medical management (CMM) in the treatment of lumbar discogenic pain.
OBJECTIVE:
The objective was to demonstrate the superiority of IDB over CMM in the treatment of discogenic pain with respect to the primary outcome measure.
SUMMARY OF BACKGROUND DATA:
Current therapeutic options for the treatment of chronic low back pain (LBP) of discogenic origin are limited. CMM is often unsatisfactory with regards to the treatment of discogenic pain. IDB offers a minimally invasive treatment that has been demonstrated to be superior to placebo in the past.
METHODS:
A total of 63 subjects with lumbar discogenic pain diagnosed via provocation discography were randomized to IDB + CMM (n = 29) or CMM-alone (n = 34). At 6-months patients in the CMM-alone group were eligible for crossover if desired. The primary outcome measure was the change in VAS from baseline to 6-months. Secondary outcome measures included treatment "responders", defined as the proportion of subjects with a 2-point or 30% decrease in VAS scores. Other secondary measures included changes from baseline to 6-months in: 1) short form (SF) 36-physical functioning (SF36-PF), 2) Oswestry Disability Index (ODI), 3) Beck Depression Inventory (BDI), 4) Patient Global Impression of Change (PGIC), 5), EQ-5D VAS, and 6) back pain-related medication usage.
RESULTS:
In the IDB cohort the mean VAS score reduction exceeded that in the CMM cohort (-2.4 vs. -0.56; p = 0.02), and the proportion of treatment responders was substantially greater (50% vs. 18%). Differences in secondary measures favored IDB. No differences in opioid utilization were noted between groups.
CONCLUSIONS:
Superior performance of IDB with respect to all study outcomes suggests that it is a more effective treatment for discogenic pain than CMM-alone.
LEVEL OF EVIDENCE:
2.

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COMENTARIO

Aunque la administración de radiofrecuencia no es un procedimiento nuevo las técnicas anteriormente aplicadas no resultaban eficaces en el campo de la analgesia, este estudio propone una forma de aplicación que podría dar una analgesia efectiva incluso de un año en algunos pacientes respecto al tratamiento conveccional en dolor discogénico lumbar en... + Leer más

Aunque la administración de radiofrecuencia no es un procedimiento nuevo las técnicas anteriormente aplicadas no resultaban eficaces en el campo de la analgesia, este estudio propone una forma de aplicación que podría dar una analgesia efectiva incluso de un año en algunos pacientes respecto al tratamiento conveccional en dolor discogénico lumbar en humanos.

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