Clinical Radiofrequency Ablation Outcomes of Combined Sensory Nerve Branch and Dorsal Entry Root Zone Complex Lesions for Sacroiliac Joint Complex Pain

Sam, Jordan; Pastrak, Mila; Duda, Larysa; Vladicic, Nikola; Vrooman, Bruce; Ma, Frederick; Khandwalla, Farhan; Abd‐Elsayed, Alaa; Catapano, Michael; McGilvray, Scott; Khan, James S.; Visnjevac, Ognjen

doi:10.1007/s12325-022-02183-5

Cited by 5 publications

(2 citation statements)

References 28 publications

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“…14,15 RF ablation is a recognized method for treating chronic pain syndromes, creating thermal damage to target nerves. 25,26 RF destruction can be performed percutaneously through a small skin puncture, unlike traditional surgical rhizotomy that requires a multilevel laminectomy. 11 The minimally invasive nature of RF ablation makes it an attractive option, especially in the pediatric population, where more aggressive interventions may carry greater risk.…”

Section: Discussionmentioning

confidence: 99%

“…8 This technique is minimally invasive and is typically performed transcutaneously under radioscopic guidance for placing electrode tips near ganglia or spinal roots at the lumbar level, corresponding to lower-limb innervation. 13,15,26 Heating causes partial sensory denervation, reducing hyperexcitability of the stretch reflex and the corresponding muscle hypertonus. The advantages of RF ablation include the ability to perform minimally invasive bilateral treatment of multiple spinal levels simultaneously.…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous thermal radiofrequency rhizotomy of L2–S1 spinal nerve roots in children with cerebral palsy

Shapkin,

Iakimov,

Sufianov

et al. 2024

Neurosurgical Focus

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OBJECTIVE This study presents the results of an evaluation of the effectiveness of percutaneous thermal radiofrequency (RF) ablation of spinal nerve roots to reduce spasticity and improve motor function in children with cerebral palsy (CP). METHODS A retrospective analysis was conducted on the surgical treatment outcomes of 26 pediatric patients with severe CP (Gross Motor Function Classification System levels IV–V). The assessment protocol included muscle tone assessment using the modified Ashworth scale (MAS), evaluation of passive and active range of motion, gait video recording, and locomotor status evaluation using the Gross Motor Function Measure (GMFM)–88 scale. Thermal RF rhizotomy (ablation of spinal nerve roots) was performed on all patients at the L2–S1 levels at 70°C for 90 seconds. The statistical data analysis was conducted using the t-test and Mann-Whitney U-test. A p value < 0.05 was considered statistically significant. RESULTS Before the operation, the average level of spasticity in the lower-limb muscles of all patients was 3.0 ± 0.2 according to the MAS. In the early postoperative period, the spasticity level in all examined muscle groups significantly decreased to a mean of 1.14 ± 0.15 (p < 0.001). In the long-term postoperative period, the spasticity level in the examined muscle groups averaged 1.49 ± 0.17 points on the MAS (p < 0.001 compared to baseline, p = 0.0416 compared to the early postoperative period). Despite the marked reduction of spasticity in the lower limbs, no significant change in locomotor status according to the GMFM-88 scale was observed in the selected category of patients. In the long-term period, during the control examination of patients, the GMFM-88 level increased on average by 3.6% ± 1.4% (from 22.2% ± 3.1% to 25.8% ± 3.6%). CONCLUSIONS The findings of this study offer preliminary yet compelling evidence that RF ablation of spinal nerve roots can lead to a significant and enduring decrease in muscle tone among children with severe spastic CP. Further studies and longer-term data of the impact on functionality and quality of life of patients with CP after spinal root RF ablation are needed.

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