Medical Minutes
Pulsed radiofrequency may help relieve back pain and sciatica
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 new study presented at 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 jelly-like material in the center of the disk bulges through a tear in the disk’s 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 over-the-counter pain medications to injections of corticosteroids directly into the affected area of the spine. Those who don’t respond may require surgery. In some cases, the entire disk must be removed and the vertebra fused together for stability. An alternative technique, CT-guided pulsed radiofrequency 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 Dr. Alessandro Napoli, who is a 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 128 patients, the pulsed radiofrequency treatment was delivered directly under CT guidance to the root of the nerve. The treatment was applied for 10 minutes. For comparison, a group of 120 patients received one to three sessions of CT-guided steroid injection on the same anatomical target with no pulsed radiofrequency.
The one-year outcomes demonstrated that CT-guided pulsed radiofrequency was superior to the injection-only strategy. Patients who received it saw greater overall improvement in pain and disability scores during the first year. Relief of leg pain was faster in patients assigned to pulsed radiofrequency, and they also reported a faster rate of perceived recovery. The probability of perceived recovery after one year of follow-up was 95 percent in the pulsed radiofrequency group compared with 61 percent in the injection only group.
Combating memory loss with diet
Eating leafy greens, dark orange vegetables, red vegetables, berry fruits and drinking orange juice may be associated with a lower risk of memory loss over time, according to a new study out of Harvard. Researchers looked at 27,842 men with an average age of 51 who were all health professionals and found that a diet rich in fruits and vegetables may help prevent memory loss.
Participants filled out questionnaires about how many servings of fruits, vegetables and other foods they had each day at the beginning of the study and then every four years for 20 years. A serving of fruit is considered one cup of fruit or a half cup of fruit juice. A serving of vegetables is considered one cup of raw vegetables or two cups of leafy greens.
“One of the most important factors in this study is that we were able to research and track such a large group of men over a 20-year period of time, allowing for very telling results,” said study author Changzheng Yuan, who is with Harvard T.H. Chan School of Public Health in Boston. “Our studies provide further evidence dietary choices can be important to maintain your brain health.”
The study showed that men who consumed the most vegetables were 34 percent less likely to develop poor thinking skills than the men who consumed the least amount of vegetables. The men who drank orange juice every day were 47 percent less likely to develop poor thinking skills than the men who drank less than one serving per month.
Adding more cranberries to your diet
Adding cranberries to your diet on a regular basis may not only help with memory but also lower your risk for infections. For centuries, cranberries have had a reputation for boosting health, dating back to Native-Americans who used them to treat urinary tract infections as well as wounds and other ailments. In more recent years, the fruit has been found to have other potential health benefits, according to Amy Howell, who is a research scientist at Rutgers University.
Howell said a specific compound in cranberries called proanthocyanidins (PACs) helps to prevent bacteria from sticking to the urinary tract, so they can’t multiply and cause infection. This discovery by Howell and Nick Vorsa, which was published in 1998 in The New England Journal of Medicine, has led to further studies that suggest consuming cranberries regularly can help prevent certain bacterial infections.
“Often, urinary tract infections recur, requiring patients to take daily doses of antibiotics to keep infections at bay. Prolonged antibiotic use has resulted in bacterial resistance problems and left researchers searching for alternatives,” said Howell. “The compounds in cranberries may contribute to inhibiting the bacteria from sticking to the bladder wall without actually killing them, so they prevent infections without contributing to bacterial resistance problems.”
She said consuming cranberry products regularly can help prevent urinary tract infections and recent studies suggest they may also help in suppressing bacteria that cause stomach ulcers. Howell said that since cranberries contain antioxidants, they may also help to lower oxidative stress, an imbalance that causes numerous chronic diseases, including inflammation, diabetes, rheumatoid arthritis and cardiovascular disease. Howell said about a half cup of cranberry sauce or dried berries, a 10-ounce glass of cranberry juice drink (sweetened or unsweetened, with at least 25 percent cranberry) or certain dried encapsulated supplements may have beneficial effects.
John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com.
John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.
