Occipital Nerve Pulsed Radiofrequency Treatment: A Multi-Center Study Evaluating Predictors of Outcome

Abstract

PRF may provide intermediate-term benefit in ON to a significant proportion of refractory cases. Careful attention to selection criteria and treatment parameters may further improve treatment outcomes.

Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment

“…Similarly, no differences for cervical and lumbar facet RF denervation outcomes have been noted when 50 and 80% cutoff thresholds were compared [91,98]. The results for RF denervation are consistent with other treatments that have found no differences in outcomes between using 50% thresholds for screening procedures and more stringent reference standards (Table 6) [99,100].…”

Interdisciplinary management of headache disorders

“…117,118 Although the results from most of the reported case series and studies are favorable, there is currently little convincing evidence for the efficacy of GON blockade in the acute or preventive treatment of headache, as most data on this topic come from noncontrolled studies. Pulsed radiofrequency ablation [119][120][121][122] and botulinum toxin injection 123 to the occipital nerves have been reported in the recent literature and have shown to provide potential long-term relief for patients with occipital neuralgia. Further studies are needed to determine the role of GON block in headache disorders.…”

Radiofrequency Procedures to Relieve Chronic Knee Pain

“…Only 3 studies 17,20,34 of the 6 studies described use of prognostic nerve blocks prior to ablative (conventional or cooled) RF treatments. Studies by Choi et al 17 and Protzman et al 34 used relatively high volumes of local anesthetic (2 mL), which have been shown to undermine the specificity of diagnostic and prognostic injections, 44 and spread to an area of tissue exponentially larger than the lesions created using 22-gauge electrodes heated at 70°C for 90 seconds. Higher volumes were also associated with poorer treatment outcomes in a study to determine factors associated with treatment success for pulsed RF of the occipital nerves.…”

“…Higher volumes were also associated with poorer treatment outcomes in a study to determine factors associated with treatment success for pulsed RF of the occipital nerves. 44 The mechanistic basis of this phenomenon (suppression of C-fiber afferent activity) has also been elucidated. 45 In addition, Choi and colleagues' decision to require 24 hours of pain relief after a single block with lidocaine 17 is inconsistent with the pharmacodynamics of the drug.…”