"A minimally invasive procedure in which pulses of energy from a probe are applied directly to nerve roots near the spine is safe and effective in people with acute lower back pain that has not responded to conservative treatment according to a study being presented today at the annual meeting of the Radiological Society of North America RSNA. Lumbar disk herniation is a common often debilitating condition that affects the disks that act as cushions between the vertebrae of the lower spine. Herniation occurs where the jellylike material in the center of the disk bulges through a tear in the disks tough exterior layer and puts pressure on the roots of the nerves. Herniated disks are often the source of sciatica or pain that radiates downward from the lower back into the leg.  Conservative treatment options for herniated disks range from overthecounter pain medications to injections of corticosteroids directly into the affected area of the spine. Those who dont respond may require surgery. In some cases the entire disk must be removed and the vertebra fused together for stability. An alternative technique CTguided pulsed radiofrequency pRF applies energy through an electrode under CT guidance to the portion of the nerve responsible for sending pain signals. Pulsed radiofrequency creates a nerve modulation significantly reducing inflammation and its associated symptoms said study senior author Alessandro Napoli M.D. Ph.D. professor of interventional radiology at Sapienza University of Rome in Italy. Dr. Napoli and colleagues studied the approach in patients with back pain from lumbar disk herniation that had not responded to prolonged conservative treatment. In  patients the pRF treatment was delivered directly under CT guidance to the root of the nerve. The treatment was applied for  minutes.  For comparison a group of  patients received one to three sessions of CTguided steroid injection on the same anatomical target with no pRF.  The oneyear outcomes demonstrated that CTguided pRF was superior to the injectiononly strategy. Patients who received pRF saw greater overall improvement in pain and disability scores during the first year. Relief of leg pain was faster in patients assigned to pRF and they also reported a faster rate of perceived recovery. The probability of perceived recovery after one year of followup was  percent in the pRF group compared with  percent in the injection only group.  Given our study results we offer pulsed radiofrequency to patients with herniated disk and sciatic nerve compression whose symptoms do not benefit from conservative therapy Dr. Napoli said. The results of the study are superior to those typically reported for usual care strategies and injections and may help a substantial number of patients with sciatic disk compression to avoid surgery Dr. Napoli added.  The use of pRF also could improve outcomes for patients set to receive corticosteroid injections. We learned that when pulsed radiofrequency is followed by steroid injection the result is longer lasting and more efficacious than injection only Dr. Napoli said. The effect of pulsed radiofrequency is fast and without adverse events. Today therapy for spine disorders allows for definitive treatment of symptoms and conditions using different techniques and technologies.  Of the different therapies available pulsed radiofrequency is among the least invasive Dr. Napoli said. Treatment lasts  minutes and one session was enough in a large number of treated patients. Coauthors are Roberto Scipione M.D. Fabrizio Andrani M.D. Susan Dababou Cristina Marrocchio Michele Anzidei M.D. and Carlo Catalano M.D.   Note Copies of RSNA  news releases and electronic images will be available online at RSNA.orgpress httpspress.rsna.orgtimssnetmediarsnanewsroom.cfm beginning Monday Nov. .  RSNA is an association of over  radiologists radiation oncologists medical physicists and related scientists promoting excellence in patient care and health care delivery through education research and technologic innovation. The Society is based in Oak Brook Ill. RSNA.org https Editors note The data in these releases may differ from those in the published abstract and those actually presented at the meeting as researchers continue to update their data right up until the meeting. To ensure you are using the most uptodate information please contact us. For patientfriendly information on imageguided therapies visit RadiologyInfo.org https"