Pulsed Radiofrequency Procedures in Clinical Practice

Rosenthal, Richard M.

doi:10.1007/978-1-4419-0352-5_9

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…It is thought that PRF lesioning selectively affects C and A-delta fibers responsible for conveying pain and temperature sensations and does not affect motor fibers 32 . As long as fluid is not injected into the nerve axon itself, there are no reported cases of persistent motor nerve damage or motor function loss 33 . The use of PRF rather than conventional radiofrequency lesioning keeps the temperature <45°C, which is thought to be the threshold at which neural tissue thermal damage occurs 34 .…”

Section: Discussionmentioning

confidence: 99%

The Impact of Suprascapular Nerve Interventions in Patients with Frozen Shoulder

et al. 2021

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Background: Frozen shoulder is a common condition resulting in severe pain and restricted range of motion. An assessment of the effectiveness of interventions may provide an improved understanding of the development and management of frozen shoulder.Methods: A literature search was conducted using Embase, the Cumulative Index of Nursing and Allied Health (CINAHL), the Cochrane Central Register of Controlled Trials (CENTRAL), and National Center for Biotechnology Information PubMed using relevant terms. Studies were included if they assessed the outcomes of interventions on the suprascapular nerve that aim to improve the symptoms of frozen shoulder.Results: A database search returned 196 articles. After review, 9 articles met the inclusion criteria and were included in the analysis. Suprascapular nerve interventions (nerve block, pulsed radiofrequency lesioning) are associated with improvement in pain, motion, and function. Meta-analysis showed that pain (Hedges g, 23.084 [95% confidence interval (CI), 24.273 to 21.894]; p , 0.001) and range of motion (Hedges g, 2.204 [95% CI, 0.992 to 3.415]; p , 0.001) improved significantly following suprascapular nerve block (SSNB).Conclusions: SSNB is associated with significant improvements in shoulder pain and range of motion in patients with frozen shoulder. Further randomized controlled trials comparing SSNB with intra-articular injection and other nonoperative treatments are required to fully define its role in the management of frozen shoulder.

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Section: Discussionmentioning

confidence: 99%

The Impact of Suprascapular Nerve Interventions in Patients with Frozen Shoulder

et al. 2021

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“… 13 PRF ablation keeps tissue under the neurodestructive temperature threshold; thus, the risk of unwanted thermal disruption to the surrounding tissues is mitigated. 14 While the exact mechanism of action of PRF is uncertain, most explanations focus on the rapidly alternating electric fields generated and their neuromodulatory effects. 2 , 15 This creates microscopic damage to mitochondria and disorganization of microfilaments and microtubules of the axons.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation of the Stellate Ganglion for Management of Acute Digital Ischemia: A Case Report

2018

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The authors present a report of a pulsed radiofrequency ablation of the stellate ganglion performed on a patient with microemboli to the hand from a thrombosed abandoned arteriovenous fistula. The patient was initially managed using vasodilators and anticoagulation. However, the patient’s skin mottling, pain, and decreased strength persisted. Ablation of the stellate ganglia increased perfusion to his hand and likely prevented amputation that has lasted for approximately 1 year. While radiofrequency ablation is more commonly used for pain syndromes, this is an example of its use in the treatment and potential treatment of acute ischemia.

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“…The maximum current is produced from the needle tip under pulse mode, and forms an oval electric field. Therefore, the vertical relationship between the needle tip and the targeted nerve is critical and a prerequisite for PRF therapy (9,31,38). On the other hand, in conventional DRG-targeting PRF, it is rather difficult to keep the verticality between the electrode and the nerve, and hence may not be as effective.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Pulsed Radiofrequency in the Treatment of Thoracic Postherpetic Neuralgia from the Angulus Costae: A Randomized, Double-Blinded, Controlled Trial

Fan²,

Jin³

et al. 2013

Pain Phys

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Background: Postherpetic neuralgia (PHN) is often refractory to existing treatments. Pulsed radiofrequency (PRF) is known to be effective for treating neuropathic pain. In common, the targets of PRF treatment were the segmental dorsal root ganglion (DRG) neurons responsible for the pain. A potential complication that can occasionally occur with PRF treatment is damage to the adjacent tissue and organ. The effectiveness of the angulus costae as a puncture site for PRF has not been tested in thoracic PHN treatment. Objective: The goal of this study was to investigate the therapeutic efficacy and safety of PRF for treating thoracic PHN through the puncture of the angulus costae. Study Design: Prospective, randomized, double-blinded study. Setting: Department of Anesthesiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine. Methods: Ninety-six patients with thoracic (T2-11) PHN were equally randomized assigned into 2 groups. The electrode needle punctured through the angulus costae of each patient guided by x-ray; PRF at 42°C for 120 seconds was applied after inducing paresthesia involving the affected dermatome area. PRF was applied in the PRF group (n = 48) twice. It was also applied in the sham group (n = 48) twice without radiofrequency energy output. The treatment was done once a week for 3 weeks. Tramadol was used for flare pain when the visual analog scale (VAS) ≥ 3. Outcomes Assessment: The therapeutic effect was evaluated by VAS, SF-36 health survey questionnaire, side effects (type, frequency, and onset time) before treatment, at days 3, 7, and 14, and at months one, 2, 3 and 6 after PRF. The average of tramadol (mg/d) administrated within the first month after treatment was also recorded. Results: The postprocedure VAS scores in the PRF group were significantly lower than those in the sham group and lasted for 6 months after treatment (P < 0.05). The SF-36 score, such as physical functioning, physical role, bodily pain, general health perceptions, social function, emotional role, and mental health index were significantly improved until 6 months after treatment in the PRF group compared to the sham group (P < 0.01-0.05). The average dosage of tramadol administered (mg/d) within the first month after treatment was also significantly reduced in the PRF group compared to the sham group (P < 0.05). There were no obvious signs of pneumothorax, bleeding, infection, or other severe side effects in either group (P > 0.05). Limitations: Single center study, relatively small number of patients. Conclusions: The strategy that the angulus costae be used as the PRF puncture point of an electrode needle and the final localization of the needle tip as determined by sensory testing is an effective and safe therapeutic alternative for thoracic PHN treatment. Benefits include that the procedure is minimally invasive, provides short-term pain relief, and improves quality of life. Clinical Trial Registration: NO ISRCTN25588650. Key words: Thoracic, postherpetic neuralgia, pulsed radiofrequency, angulus costae

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Pulsed Radiofrequency Procedures in Clinical Practice

Cited by 5 publications

References 33 publications

The Impact of Suprascapular Nerve Interventions in Patients with Frozen Shoulder

The Impact of Suprascapular Nerve Interventions in Patients with Frozen Shoulder

Radiofrequency Ablation of the Stellate Ganglion for Management of Acute Digital Ischemia: A Case Report

Efficacy of Pulsed Radiofrequency in the Treatment of Thoracic Postherpetic Neuralgia from the Angulus Costae: A Randomized, Double-Blinded, Controlled Trial

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