Efectividad y seguridad de radiofrecuencia pulsada intracanal del ganglio de la raíz dorsal en dolor lumbar crónico radicular

El dolor lumbar es una de las principales causas de discapacidad a nivel mundial y su prevalencia aumenta persistentemente. En el año 2020, afectaba a 619 millones de personas y se estima un incremento aproximado del 36% para el año 2050. El dolor lumbar crónico, definido como aquel que perdura más...

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Ramirez Martinez, Alejandro
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https://purl.org/coar/resource_type/c_7a1f
Fecha de publicación:
2025
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Universidad El Bosque
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Repositorio U. El Bosque
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spa
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https://hdl.handle.net/20.500.12495/15722
Palabra clave:
Dolor lumbar Crónico
Dolor lumbar radicular
Medicina del dolor
Radiofrecuencia Pulsada intracanal
Chronic low back pain
Radicular low back pain
Intracanal Pulsed radiofrequency
Pain medicine
WB 310
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network_name_str Repositorio U. El Bosque
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dc.title.none.fl_str_mv Efectividad y seguridad de radiofrecuencia pulsada intracanal del ganglio de la raíz dorsal en dolor lumbar crónico radicular
dc.title.translated.none.fl_str_mv Effectiveness and Safety of Intracanal Pulsed Radiofrequency of the Dorsal Root Ganglion in Chronic Lumbar Radicular Pain
title Efectividad y seguridad de radiofrecuencia pulsada intracanal del ganglio de la raíz dorsal en dolor lumbar crónico radicular
spellingShingle Efectividad y seguridad de radiofrecuencia pulsada intracanal del ganglio de la raíz dorsal en dolor lumbar crónico radicular
Dolor lumbar Crónico
Dolor lumbar radicular
Medicina del dolor
Radiofrecuencia Pulsada intracanal
Chronic low back pain
Radicular low back pain
Intracanal Pulsed radiofrequency
Pain medicine
WB 310
title_short Efectividad y seguridad de radiofrecuencia pulsada intracanal del ganglio de la raíz dorsal en dolor lumbar crónico radicular
title_full Efectividad y seguridad de radiofrecuencia pulsada intracanal del ganglio de la raíz dorsal en dolor lumbar crónico radicular
title_fullStr Efectividad y seguridad de radiofrecuencia pulsada intracanal del ganglio de la raíz dorsal en dolor lumbar crónico radicular
title_full_unstemmed Efectividad y seguridad de radiofrecuencia pulsada intracanal del ganglio de la raíz dorsal en dolor lumbar crónico radicular
title_sort Efectividad y seguridad de radiofrecuencia pulsada intracanal del ganglio de la raíz dorsal en dolor lumbar crónico radicular
dc.creator.fl_str_mv Ramirez Martinez, Alejandro
dc.contributor.advisor.none.fl_str_mv Guerrero Nope, Carlos Eduardo
dc.contributor.author.none.fl_str_mv Ramirez Martinez, Alejandro
dc.contributor.orcid.none.fl_str_mv Ramirez Martinez, Alejandro [0000-0002-2339-6752]
dc.subject.none.fl_str_mv Dolor lumbar Crónico
Dolor lumbar radicular
Medicina del dolor
Radiofrecuencia Pulsada intracanal
topic Dolor lumbar Crónico
Dolor lumbar radicular
Medicina del dolor
Radiofrecuencia Pulsada intracanal
Chronic low back pain
Radicular low back pain
Intracanal Pulsed radiofrequency
Pain medicine
WB 310
dc.subject.keywords.none.fl_str_mv Chronic low back pain
Radicular low back pain
Intracanal Pulsed radiofrequency
Pain medicine
dc.subject.nlm.none.fl_str_mv WB 310
description El dolor lumbar es una de las principales causas de discapacidad a nivel mundial y su prevalencia aumenta persistentemente. En el año 2020, afectaba a 619 millones de personas y se estima un incremento aproximado del 36% para el año 2050. El dolor lumbar crónico, definido como aquel que perdura más de 3 meses, afecta gravemente la funcionalidad y suele acompañarse de depresión y ansiedad generando un ciclo de afectación de la calidad de vida y limitación funcional. El dolor lumbar radicular resultado de la compresión de raíces nerviosas afecta entre el 13 al 40% de la población. Los tratamientos conservadores como fármacos o fisioterapia, tienen una eficacia limitada. La radiofrecuencia pulsada epidural del ganglio de la raíz dorsal por vía intra canal bajo guía fluoroscopia coma ha mostrado alivio del dolor mejoría en la calidad de vida y menor dependencia a analgésicos. Diseño materiales y métodos: Se llevó a cabo un estudio observacional analítico retrospectivo de serie de casos en el hospital universitario santa fe de Bogotá Es inclusión de pacientes adultos atendidos entre marzo de 2024 y marzo de 2025. Se seleccionó a pacientes mayores de 18 años con dolor lumbar radicular crónico mayor de 3 meses de evolución, escala numérica del dolor mayor o igual a 5 con refractaria al tratamiento convencional. El muestreo fue no probabilístico por conveniencia. Se analizaron todas las historias clínicas de los pacientes que cumplieron criterios de inclusión y se realizó seguimiento en los controles clínicos periódicos y en aquellos casos donde no se completaron los datos contacto vía telefónica. El análisis estadístico aplicó pruebas para definir El grado de mejoría del dolor y respuesta al tratamiento al igual que la mejoría con escalas de valoración funcional al igual que las complicaciones registradas en este periodo de seguimiento. Resultados: Se observó una mejoría clínicamente significativa en términos de intensidad del dolor y mejoría de la limitación funcional por escalas de valoración física. Se observó diferencia estadísticamente significativa en la disminución de los valores de escala numérica del dolor al igual que la puntuación de las escalas de limitación funcional en los periodos de seguimiento clínico. No se identificó complicaciones neurológicas mayores asociadas al procedimiento. Se terminó la dosis de radiación total promedio, por área y por numero de niveles intervenidos
publishDate 2025
dc.date.accessioned.none.fl_str_mv 2025-08-13T15:20:54Z
dc.date.available.none.fl_str_mv 2025-08-13T15:20:54Z
dc.date.issued.none.fl_str_mv 2025-07
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.local.spa.fl_str_mv Tesis/Trabajo de grado - Monografía - Especialización
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dc.relation.references.none.fl_str_mv 1. Gulduren Aydın LG, Akesen S, Turker YG, Gurbet A, Kılıç Yılmaz V. Investigation of Effectiveness of Pulsed Radiofrequency With Multifunctional Epidural Electrode for Low Back Pain. Cureus. 2021 Dec 7;
2. Li X, Yang Y, Huang D, Ma J, Huang Y. Pulsed Radiofrequency Relieves Neuropathic Pain by Repairing the Ultrastructural Damage of Chronically Compressed Dorsal Root Ganglion. Neurosci Insights. 2025 Jan 1;20.
3. Krames ES. The dorsal root ganglion in chronic pain and as a target for neuromodulation: A review. Neuromodulation. 2015 Jan 1;18(1):24–32.
4. Park D, Chang MC. The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review. Vol. 39, Journal of Yeungnam Medical Science. Yeungnam University School of Medicine and College of Medicine; 2022. p. 200–5.
5. Ferreira ML, De Luca K, Haile LM, Steinmetz JD, Culbreth GT, Cross M, et al. Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023 Jun 1;5(6):e316–29.
6. Knezevic NN, Candido KD, Vlaeyen JWS, Van Zundert J, Cohen SP. Low back pain. Vol. 398, The Lancet. Elsevier B.V.; 2021. p. 78–92.
7. Meucci RD, Fassa AG, Xavier Faria NM. Prevalence of chronic low back pain: Systematic review. Vol. 49, Revista de Saude Publica. Universidade de Sao Paulo; 2015.
8. Farley T, Stokke J, Goyal K, DeMicco R. Chronic Low Back Pain: History, Symptoms, Pain Mechanisms, and Treatment. Life. 2024 Jun 27;14(7):812.
9. Deyo RA, Dworkin SF, Amtmann D, Andersson G, Borenstein D, Carragee E, et al. Report of the NIH task force on research standards for chronic low back pain. Journal of Pain. 2014;15(6):569–85
10. Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Vol. 64, Arthritis and Rheumatism. 2012. p. 2028–37.
11. Freburger JK, Holmes GM, Agans RP, Jackman AM, Darter JD, Wallace AS, et al. The Rising Prevalence of Chronic Low Back Pain.
12. Dower A, Davies MA, Ghahreman A. Pathologic Basis of Lumbar Radicular Pain. Vol. 128, World Neurosurgery. Elsevier Inc.; 2019. p. 114–21.
13. Alfalogy E, Mahfouz S, Elmedany S, Hariri N, Fallatah S. Chronic Low Back Pain: Prevalence, Impact on Quality of Life, and Predictors of Future Disability. Cureus. 2023 Sep 22;
14. Shmagel A, Foley R, Ibrahim H. Epidemiology of Chronic Low Back Pain in US Adults: Data From the 2009–2010 National Health and Nutrition Examination Survey. Arthritis Care Res (Hoboken). 2016 Nov 1;68(11):1688–94.
15. Corrêa LA, Mathieson S, Meziat-Filho NA de M, Reis FJ, Ferreira A de S, Nogueira LAC. Which psychosocial factors are related to severe pain and functional limitation in patients with low back pain?: Psychosocial factors related to severe low back pain. Braz J Phys Ther. 2022 May 1;26(3).
16. Sayed D, Grider J, Strand N, Hagedorn JM, Falowski S, Lam CM, et al. The American Society of Pain and Neuroscience (ASPN) Evidence-Based Clinical Guideline of Interventional Treatments for Low Back Pain. Vol. 15, Journal of Pain Research. Dove Medical Press Ltd; 2022. p. 3729–832.
17. Low back pain and sciatica in over 16s: assessment and management NICE guideline [Internet]. 2016.
18. Jones CMP, Day RO, Koes BW, Latimer J, Maher CG, McLachlan AJ, et al. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial. The Lancet. 2023 Jul 22;402(10398):304–12.
19. Tucker HR, Scaff K, McCloud T, Carlomagno K, Daly K, Garcia A, et al. Harms and benefits of opioids for management of non-surgical acute and chronic low back pain: a systematic review. Vol. 54, British Journal of Sports Medicine. BMJ Publishing Group; 2019. p. 664–75.
20. Nijs J, Kosek E, Chiarotto A, Cook C, Danneels LA, Fernández-de-las-Peñas C, et al. Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium’s international and multidisciplinary consensus recommendations. Vol. 6, The Lancet Rheumatology. Elsevier Ltd; 2024. p. e178–88.
21. Esposito MF, Malayil R, Hanes M, Deer T. Unique Characteristics of the Dorsal Root Ganglion as a Target for Neuromodulation. Pain Medicine (United States). 2019 Jun 1;20:S23–30.
22. Krames ES, St B. The Role of the Dorsal Root Ganglion in the Development of Neuropathic Pain [Internet]. Available from: http://www.csus.edu/
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24. Van den Heuvel SAS, Cohen SPC, de Andrès Ares J, Van Boxem K, Kallewaard JW, Van Zundert J. 3. Pain originating from the lumbar facet joints. Vol. 24, Pain Practice. John Wiley and Sons Inc; 2024. p. 160–76.
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31. Acevedo-Gonzalez JC, Ariza-Piñeros CF, Vega-Corredor JM. Anatomical and morphological variations in the dorsal root ganglion: Technical implications for chronic pain treatment with neuromodulation—A systematic review. Pain Practice. 2025 Feb 1;25(2).
32. Pierre J, Buyten V. Dorsal Root Ganglion Stimulation.
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34. Kramer J, Foster A, Kent AR, Cusack W. Fundamentals and Mechanisms of Dorsal Root Ganglion Stimulation. In: Neuromodulation: Comprehensive Textbook of Principles, Technologies, and Therapies, Second Edition: Volume 1-3. Elsevier; 2018. p. 179–91.
35. Pulsed Radiofrecuency mechanism of Action .
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37. Van Boxem K, Huntoon M, Van Zundert J, Patijn J, Van Kleef M, Joosten EA. Pulsed radiofrequency: A review of the basic science as applied to the pathophysiology of radicular pain: A call for clinical translation. Vol. 39, Regional Anesthesia and Pain Medicine. 2014. p. 149–59.
38. Erdine S, Bilir A, Cosman ER, Cosman ER. Ultrastructural changes in axons following exposure to pulsed radiofrequency fields. Pain Practice. 2009 Nov;9(6):407–17.
39. Hagiwara S, Iwasaka H, Takeshima N, Noguchi T. Mechanisms of analgesic action of pulsed radiofrequency on adjuvant-induced pain in the rat: Roles of descending adrenergic and serotonergic systems. European Journal of Pain. 2009 Mar;13(3):249–52.
40. Vigneri S. Prospective Study Effectiveness of Pulsed Radiofrequency with Multifunctional Epidural Electrode in Chronic Lumbosacral Radicular Pain with Neuropathic Features [Internet]. Vol. 17, Pain Physician. 2014. Available from: www.painphysicianjournal.com
41. Chang MC, Lee DG. Clinical effectiveness of caudal epidural pulsed radiofrequency stimulation in managing refractory chronic leg pain in patients with postlumbar surgery syndrome. J Back Musculoskelet Rehabil. 2020;33(3):523–8.
42. Voloshin A. The efficacy of epidural pulsed radiofrequency on radicular pain refractory to dorsal root ganglion pulsed radiofrequency treatment. International Physical Medicine & Rehabilitation Journal. 2021;6(3):61–5.
43. Guven Kose S, Kose HC, Celikel F, Akkaya OT. Ultrasound-guided caudal epidural pulsed radiofrequency for the treatment of failed back surgery syndrome: Results of a prospective clinical study. Interventional Pain Medicine. 2022 Dec 1;1(4).
44. Silva-Ortiz VM. Eficacia de la Radiofrecuencia Pulsada de Ganglio de la Raíz Dorsal Lumbar por Vía Epidural, Acceso Caudal para Tratar el Dolor Lumbar Crónico. Serie de Casos. Anestesia en Mexico, editor. Vol. 37. 2025. p. 40–4.
45. Erken B, Yolcu G, Saracoglu TT. Efficacy of Epidural Pulsed Radiofrequency Treatment in Persistent Spinal Pain Syndrome: A Prospective Clinical Study. Pain Res Manag. 2025;2025.
46. Vigneri S, Sindaco G. Efficacy of High-Voltage Pulsed Radiofrequency in Chronic Lumbosacral Radicular Pain: An Improved Tool? Vol. 27, Neuromodulation. International Neuromodulation Society; 2024. p. 217.
47. Cho HK, Kang JH, Kim SY, Choi MJ, Hwang J, Cho YW, et al. Experimental Trial Changes in Neuroglial Activity in Multiple Spinal Segments after Caudal Epidural Pulsed Radiofrequency in a Rat Model of Lumbar Disc Herniation. Pain Physician 2016;19:1197–209.
48. Acevedo-Gonzalez JC, Ariza-Piñeros CF, Vega-Corredor JM. Anatomical and morphological variations in the dorsal root ganglion: Technical implications for chronic pain treatment with neuromodulation—A systematic review. Pain Practice. 2025 Feb 1;25(2).
49. Zucker B, Cohen SL, Health N, Schneider R, Carrino J, Zeldin R, et al. Radiation Dose Practice Audit of 6,234 Fluoroscopically-Guided Spinal Injections.
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spelling Guerrero Nope, Carlos EduardoRamirez Martinez, AlejandroRamirez Martinez, Alejandro [0000-0002-2339-6752]2025-08-13T15:20:54Z2025-08-13T15:20:54Z2025-07https://hdl.handle.net/20.500.12495/15722instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coEl dolor lumbar es una de las principales causas de discapacidad a nivel mundial y su prevalencia aumenta persistentemente. En el año 2020, afectaba a 619 millones de personas y se estima un incremento aproximado del 36% para el año 2050. El dolor lumbar crónico, definido como aquel que perdura más de 3 meses, afecta gravemente la funcionalidad y suele acompañarse de depresión y ansiedad generando un ciclo de afectación de la calidad de vida y limitación funcional. El dolor lumbar radicular resultado de la compresión de raíces nerviosas afecta entre el 13 al 40% de la población. Los tratamientos conservadores como fármacos o fisioterapia, tienen una eficacia limitada. La radiofrecuencia pulsada epidural del ganglio de la raíz dorsal por vía intra canal bajo guía fluoroscopia coma ha mostrado alivio del dolor mejoría en la calidad de vida y menor dependencia a analgésicos. Diseño materiales y métodos: Se llevó a cabo un estudio observacional analítico retrospectivo de serie de casos en el hospital universitario santa fe de Bogotá Es inclusión de pacientes adultos atendidos entre marzo de 2024 y marzo de 2025. Se seleccionó a pacientes mayores de 18 años con dolor lumbar radicular crónico mayor de 3 meses de evolución, escala numérica del dolor mayor o igual a 5 con refractaria al tratamiento convencional. El muestreo fue no probabilístico por conveniencia. Se analizaron todas las historias clínicas de los pacientes que cumplieron criterios de inclusión y se realizó seguimiento en los controles clínicos periódicos y en aquellos casos donde no se completaron los datos contacto vía telefónica. El análisis estadístico aplicó pruebas para definir El grado de mejoría del dolor y respuesta al tratamiento al igual que la mejoría con escalas de valoración funcional al igual que las complicaciones registradas en este periodo de seguimiento. Resultados: Se observó una mejoría clínicamente significativa en términos de intensidad del dolor y mejoría de la limitación funcional por escalas de valoración física. Se observó diferencia estadísticamente significativa en la disminución de los valores de escala numérica del dolor al igual que la puntuación de las escalas de limitación funcional en los periodos de seguimiento clínico. No se identificó complicaciones neurológicas mayores asociadas al procedimiento. Se terminó la dosis de radiación total promedio, por área y por numero de niveles intervenidosHospital Universitario Fundación Santa Fe de BogotáEspecialista en Medicina del Dolor y Cuidados PaliativosEspecializaciónLow back pain is one of the leading causes of disability worldwide, and its prevalence continues to rise. In 2020, it affected 619 million people, and it is projected to increase by approximately 36% by 2050. Chronic low back pain—defined as pain lasting more than three months—severely impairs functional ability and is often accompanied by depression and anxiety, creating a cycle of reduced quality of life and disability.Radicular low back pain, resulting from nerve-root compression, affects between 13% and 40% of the population.Conservative treatments such as medications or physical therapy have limited efficacy. Epidural pulsed radiofrequency of the dorsal root ganglion via the intracanalar route under fluoroscopic guidance has demonstrated pain relief, improved quality of life, and reduced dependence on analgesics. Design, Materials, and Methods A retrospective, analytical, observational case-series study was conducted at the Hospital Universitario Fundación Santa Fe de Bogotá, including adult patients treated between March 2024 and March 2025. Patients over 18 years of age with chronic radicular low back pain of more than three months’ duration, a numerical pain score ≥ 5, and refractoriness to conventional treatment were selected. Non-probabilistic convenience sampling was used. All medical records meeting inclusion criteria were reviewed, and patients were followed during routine clinical visits or, when data were incomplete, by telephone contact. Statistical analyses were applied to determine the degree of pain improvement, treatment response, functional-status changes (using validated scales), and any complications recorded during the follow-up period. Results: A clinically significant improvement was observed in terms of pain intensity and reduction of functional limitation, as measured by physical assessment scales. A statistically significant difference was found in the decrease of numeric pain scale values as well as in the scores of functional limitation scales across clinical follow-up periods. No major neurological complications related to the procedure were identified. The average total radiation dose, dose per area, and dose per number of treated levels were recorded.application/pdfAttribution-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nd/4.0/Acceso abiertohttps://purl.org/coar/access_right/c_abf2http://purl.org/coar/access_right/c_abf2Dolor lumbar CrónicoDolor lumbar radicularMedicina del dolorRadiofrecuencia Pulsada intracanalChronic low back painRadicular low back painIntracanal Pulsed radiofrequencyPain medicineWB 310Efectividad y seguridad de radiofrecuencia pulsada intracanal del ganglio de la raíz dorsal en dolor lumbar crónico radicularEffectiveness and Safety of Intracanal Pulsed Radiofrequency of the Dorsal Root Ganglion in Chronic Lumbar Radicular PainEspecialización en Medicina del Dolor y Cuidados PaliativosUniversidad El BosqueFacultad de MedicinaTesis/Trabajo de grado - Monografía - Especializaciónhttps://purl.org/coar/resource_type/c_7a1fhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesishttps://purl.org/coar/version/c_ab4af688f83e57aa1. 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