Cooled Radiofrequency Holds Up for Back Pain: Q&A With Dr. Leonardo Kapural

Dr. Leonardo Kapural on pain managementLeonardo Kapural, MD, was lead clinical investigator for a double-blinded randomized controlled trial comparing cooled radiofrequency with the Kimberly-Clark TransDiscal Cooled Radiofrequency System for patients with discogenic and sacroiliac joint pain. He found that patients who underwent cooled radiofrequency experienced significant improvements.

Here, Dr. Kapural discusses the technology and where we can expect treatment to head in the future.

Q: How can cooled radiofrequency technology help patients with back pain?


Dr. Leonardo Kapural:
Cooled radiofrequency (cooled RF) technology is a clinically effective means of reducing pain by targeting and treating the source of low back pain more accurately. Today, we know more about anatomical targets for lesioning and therefore can provide better technologies and much better patient selection. For patients with chronic back pain, cooled RF provides an added benefit because it works with difficult anatomy which is not always the case with standard RF.

Q: What are the advantages of cooled radiofrequency technology over other treatments for low back pain?

Radiofrequency Device from Kimberly ClarkLK:
Compared to non-radiofrequency treatments, cooled RF provides a minimally invasive option with a very short recovery time and minimal tissue destruction for the patient. In regards to other radiofrequency treatments, cooled RF creates large volume, spherical lesions of up to 8 to 12 mm (standard RF lesions are smaller-sized, typically 3 to 4 mm) in nervous and disc tissue. The Transdiscal product used in this study utilizes two Coold Radiofrequency probes to create a large bi-polar lesion in the posterior aspect of the disc.

Q: What was the most significant finding from your study? How do you hope your results are used in the future?

LK:
The improvements in functional capacity and pain scores in patients with one or two levels of discogenic lower back pain were profound when compared to the sham group. Such improvements provide an evidence that biacuplasty is an effective long-term solution for those with lumbar discogenic pain and maintained disc height.

Q: How easy or difficult is it for a trained pain physician to incorporate the radiofrequency technology into their practices? What steps must the physician take?

LK:
Any pain physician who wants to use cooled RF needs to go through an appropriate training. Training is currently provided through various cadaver workshops at conferences and through the owner of the technology, Kimberly-Clark Health Care.

Q: Where do you see cooled radiofrequency technology headed in the future?

LK:
I do believe that use of cooled RF for sacroiliac joint pain and discogenic pain will become a mainstream treatment option. Several physicians are using this technology for other indications like lumbar, thoracic or cervical painful spondylosis (facet syndrome), however additional studies are needed to assess its value when compared to conventional radiofrequency.

Dr Kapural is a paid member of Kimberly-Clark’s clinical education faculty. He received no financial support for this study.

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