Pulsed Radiofrequency in the Treatment of Coccygodynia

Abstract

Amaç: Koksigodini, koksigeal bölgede ağrı ve hassasiyetle kendini gösteren klinik bir durumdur. Travma en yaygın etyolojik faktördür. Biz klasik tedavi protokolleri ile iyileşememiş koksigodinili hastalarda kaudal epidural puls radyofrekans (PRF) tedavisinin etkinliğini araştırmayı ve uzun dönem sonuçlarını incelemeyi amaçladık. Gereç ve Yöntem: Çalışmaya, ağrı kliniğimizde kaudal epidural PRF ile tedavi edilen koksigodinili 21 hasta dahil edildi. Hastaların 16'sında (%76) travma hikayesi, 3'ünde (%14) geçirilmiş cerrahi hikayesi varken, 2'sinde de (%10) nedeni ortaya konamamış koksigodini vardı. Tüm hastalar daha önceden konservatif yöntemlerle tedavi edilmişler ancak hiç birisinin ağrısı yeterince geçmemişti. Hastaların ağrı düzeyi visual analog scale (VAS) skoru ile değerlendirildi. Hasta memnuniyeti 3. hafta ve 6. aylarda subjektif hasta memnuniyeti anketi ile değerlendirildi.

Coccygodynia treated by pulsed radio frequency treatment to the Ganglion of Impar: A case series

“…Seventeen patients (81%) had > 50% reduction in pain at 6 months revie [22]. Our work demonstrates that fifteen (75%) patients either had no pain or very manageable pain at 12 months post PRF treatment to the Ganglion of Impar.…”

Application of Radiofrequency in Pain Management

“…Protect motor fibers! Also, pulsed RF are reported in the literature that it can be used in treatment of Morton's neuroma [13], coccygodynia [14], pudendal neuralgia [75], vaginismus [76], carpal tunnel syndrome [77], chronic hip pain [78], post herniorrhaphy pain [79], chronic inguinal neuralgia [80], plantar heel pain [81], osteoarthritis [82], intra-articular pain [83], plantar fascitis pain [84], tarsal tunnel syndrome [85], myofascial pain syndrome [86], postamputation phantom pain [87], meralgia paresthetica [88], lingual neuralgia [89] and chronic testicular pain [90].…”

“…It is simple and clear. Efficacy of pulsed RF has been clinically documented and has been used for chronic pain conditions for the last 20 years, but its mechanism of action is not fully understood [10][11][12][13][14]. It has been suggested to alter gene expression in neurons, by means of neuromodulation [1,11,[17][18][19][20][21][22][23].…”

“…The high temperature applied with continuous RF is neurodestructive and is usually characterized by a period of discomfort, including hypoanesthesia and a neuritis-like reaction [1,[10][11][12][13][14]. Sometimes pain may potentially worsen due to nerve regeneration and may lead to neuroma formation.…”

“…Pulsed RF which produces a lesion to nerve tissue by transmission of high-voltage current through thermocouple probe has been used as a non-or minimally neurodestructive technique alternative to heat lesions because the average tissue temperature rise is less than continuous RF with the same voltage [1,[10][11][12][13][14]. Sluijter has achieved significant pain relief using radiofrequency current at a temperature below 42°C that produced strong electromagnetic field with no thermal lesion [9][10][11].…”