CT-Guided Stellate Ganglion Pulsed Radiofrequency Stimulation for Facial and Upper Limb Postherpetic Neuralgia

Ding, Yuanyuan; Yao, Peng; Li, Hong‐Xi; Han, Zhenkai; Wang, Shimeng; Hong, Tao; Zhao, Guangyu

doi:10.3389/fnins.2019.00170

Cited by 33 publications

(33 citation statements)

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“…This energy transfer does not destroy the anatomical basis of pain impulse transmission and does not cause nerve damage and protein coagulation. It is currently believed that PRF is neuromodulation for pain relief (Ding et al, 2019;Vuka et al, 2020;Wu et al, 2020). The RF electrode produces a high-voltage electric field at the target nerve, and controlled heat is generated from ion friction, which is dissipated during the relatively long pause between pulses (Cahana et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

CT-Guided Pulsed Radiofrequency at Different Voltages in the Treatment of Postherpetic Neuralgia

et al. 2020

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BackgroundPostherpetic neuralgia (PHN) is a form of long-lasting neuropathic pain that can severely affect patients’ quality of life. Pulsed radiofrequency (PRF) has been proven to be effective in treating PHN, but the optimal radiofrequency parameters are still not well defined. This retrospective study aimed to compare the efficacy and safety of CT-guided PRF at three different voltages for the treatment of PHN patients.MethodsThis study included 109 patients with PHN involving the thoracic dermatome who were treated in the Department of Pain Management of Shengjing Hospital, China Medical University, from January 2017 to May 2019. They were divided into three groups based on the PRF voltage used: group A (45 V), group B (55 V), and group C (65 V). The PRF therapy (voltage 45, 55, and 65 V) was performed in all patients by targeting the thoracic dorsal root ganglion. After surgery, patients were followed at 3 days, 1 month, 3 months, 6 months, and 12 months. Observation at each follow-up included basic patient characteristics, visual analog scale (VAS), 36-Item Short Form Health Survey (SF-36) scores, patient satisfaction, complications, and side effects.ResultsVisual analog scale scores decreased and SF-36 scores increased for all patients in the three groups at each post-operative time point (1, 3, 6, and 12 months; all P < 0.01). Pain relief, improvement in quality of life, and overall satisfaction were more significant for patients in group C than for those in groups A and B at the 3-, 6-, and 12-month follow-ups (all P < 0.05). Patients in group B had lower VAS scores and higher overall satisfaction levels than those in group A (both P < 0.01). A small number of patients from each group (n ≤ 3) experienced mild intraoperative and post-operative complications, which bore no relationship with group assignment (all P > 0.05). At post-operative day 3, patients in group C had skin numbness affecting a larger area than patients in the other two groups (both P < 0.05), but the differences were no longer statistically significant at day 30 after the operation. All patients experienced a drop in numbness area of more than 30% after surgery.ConclusionCompared with PFR at 45 and 55 V, PFR at 65 V had superior efficacy in treating PNH, with a favorable safety profile.

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Section: Discussionmentioning

confidence: 99%

CT-Guided Pulsed Radiofrequency at Different Voltages in the Treatment of Postherpetic Neuralgia

et al. 2020

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“…19 Effective treatment modalities in medical refractory cases can be listed as stellate ganglion blockage, neuroaxial opioid application, epidural dorsal column stimulation, stellate ganglion and cervical dorsal root ganglion radiofrequency application, surgical ganglionectomy, radiculotomy, and cordotomy. 20 Peripheral nerve blocks and ganglion blockages have been shown to be transient in effect and are associated with increased frequency of complications with repeated applications. It is recommended that nerve blocks should be used to determine the benefit prior to neuroablative techniques.…”

Section: Discussionmentioning

confidence: 99%

Radiation-Induced Brachial Plexopathy in Breast Cancer and the Role of Surgical Treatment

Kıbıcı

Erok²,

Atça

2020

Indian Journal of Neurosurgery

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Objective We aimed to evaluate improvement in the pain, motor, and sensory functions after neurosurgical intervention, by objective methods in patients with radiation-induced brachial plexopathy (RIBP), as a complication of radiotherapy (RT). Materials and Methods In our study, 11 patients, who experienced grade 3 or 4 brachial plexopathy according to the LENT-SOMA (late effects of normal tissue—subjective, objective, management, analytic) side-effect index, as a complication of RT which was performed after being operated for breast cancer, were included. In the postoperative period pain, sensation, and motor function loss were followed. Results There was apparent regression in the pain. The mean visual analogue scale (VAS) value decreased to 4 from the preoperative VAS value of 9.4. However, no significant improvement was observed in either sensory and motor functions. Conclusion RIBP is a progressive disease in breast cancer patients after radiotherapy. Evaluation of the results of applied surgical treatments and changes in the results with time is important to direct the treatment. Neurolysis should only be considered when other treatment methods fail and should be considered as an irreversible and potentially permanent procedure.

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“…At present, it is believed that the analgesic effect of PRF may be due to the temporary blocking of neural signals by neurons through the nerve conduction pathway, while the analgesic effect of CRF may be through the permanent blocking of neural signals through the neural pathway 19 . At present, in the clinic, the radio frequency is used to treat neuralgia 20 and has been used extensively, such as in the case of paroxysmal collective headache 24 , primary trigeminal neuralgia 21,25−27 , glossopharyngeal neuralgia 28 , postherpetic neuralgia 15,17,18,29 , chronic knee pain 16 and postherpetic trigeminal neuralgia 30 . In addition, certain studies on the use of different radio frequency modes for the treatment of neuralgia have been carried out consecutively.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy of Unipolar and Bipolar Spinal Dorsal Root Ganglion Radiofrequency Thermocoagulation in the Treatment of Postherpetic Neuralgia: a Retrospective Study

Zhu

Xie

Liu

et al. 2020

Preprint

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Background: At present, different views have been proposed on the radiofrequency treatment modes and parameters of radiofrequency thermocoagulation of the spinal dorsal root ganglion for the treatment of postherpetic neuralgia. It is urgent to identify a novel and more effective radiofrequency therapy for patients with postherpetic neuralgia. Methods: A total of 60 patients who underwent radiofrequency thermocoagulation therapy for postherpetic neuralgia in the pain department of our Hospital were retrospectively reviewed from January 2013 to November 2017. According to the different surgical methods, the patients were divided into the following groups: unipolar group (CRF) and bipolar group (DCRF). Subsequently, the pain scores (NRS) were evaluated at the following specific time points: before the operation, on the 1st day after the operation, in 3 and 6 months after the operation and in 1 and 2 years after the operation. Moreover, the incidence of intraoperative and postoperative complications and the degree of pain relief were evaluated in order to assess the efficacy and prognosis of radiofrequency thermocoagulation in the two groups. The in vitro ovalbumin experiment was used to indicate the effects of unipolar and bipolar radiofrequency thermocoagulation.Results: In this study, the intra-group comparison indicated that compared with the preoperative NRS, the postoperative NRS decreased significantly; the inter-group comparison demonstrated that the NRS of the DCRF group was lower than that of the CRF group at all time points from 6 months to 2 years following the operation. The total effective rate of the DCRF group was significantly higher than that of the CRF group in 2 years following the operation. The incidence of numbness in the DCRF group was higher than that noted in the CRF group at each time point following the operation. The ovalbumin experiments in vitro indicated that the effects of radiofrequency thermocoagulation were optimal when the distance between the two needles was 5 mm.Conclusion: Bipolar spinal root ganglion radiofrequency thermocoagulation exhibits a longer duration and higher effective rate in the treatment of postherpetic neuralgia and it’s a treatment method worth promoting.

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CT-Guided Stellate Ganglion Pulsed Radiofrequency Stimulation for Facial and Upper Limb Postherpetic Neuralgia

Cited by 33 publications

References 40 publications

CT-Guided Pulsed Radiofrequency at Different Voltages in the Treatment of Postherpetic Neuralgia

CT-Guided Pulsed Radiofrequency at Different Voltages in the Treatment of Postherpetic Neuralgia

Radiation-Induced Brachial Plexopathy in Breast Cancer and the Role of Surgical Treatment

Evaluation of the Efficacy of Unipolar and Bipolar Spinal Dorsal Root Ganglion Radiofrequency Thermocoagulation in the Treatment of Postherpetic Neuralgia: a Retrospective Study

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