[Effectiveness of Pulsed Radiofrequency on Peripheral Nerves in Severe Refractory Focal Spasticity: An Ambispective Observational Study]

Abstract

Objectives: To evaluate the efficacy and safety of pulsed radiofrequency (PRF) in spasticity.

Design: Ambispective observational study of patients with spasticity refractory to conventional treatment, enrolled from July/2019 to December/2024 and treated with PRF.

Materials and methods: The following scales were evaluated: Modified Ashworth (MAS), Visual Analogue (VAS) before, 2 and 6 months after the procedure, and GAS, PGA and PGI-C. The study was approved by the Galician Ethics Committee for Pharmaceutical Research (registration number 2023/153). All patients signed the informed consent form. We used the Wilcoxon test to analyse significant differences, concordance using Cohen's Kappa Coefficient for MAS and Intraclass Correlation Coefficient (ICC) for VAS.

Results: 22 patients were included in the study. There were no significant differences between baseline MAS and at 2 months (p=0.096) and 6 months (p=0.257), nor between baseline VAS and at 2 months (p=0.109) and 6 months (p=0.102). Agreement was moderate between baseline and 2-month MAS (Kappa=0.549, p<0.001), good between baseline and 6-month MAS (Kappa=0.698, p<0.001), and excellent for both baseline and 2-month VAS (ICC=0.935, p<0.001) and 6-month VAS (ICC=0.975, p<0.001). The mean GAS, PGA and PGI-C at 6 months were -1.35, 0.1 and 0.05, respectively. No adverse events were observed.

Conclusions: (PRF) at 45V appears to be ineffective for the treatment of spasticity and related pain. Further research is warranted to confirm these findings.

Keywords: Espasticidad focal; Espasticidad refractaria; Focal spasticity; Intervención ecoguiada; Nervios periféricos; Peripheral nerves; Peripheral pulsed radiofrequency; Radiofrecuencia pulsada periférica; Refractory spasticity; Ultrasound-guided intervention..