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Pain radiofrequency denervation

Maarten van Eerd, Arno Lataster, Micha Sommer, Jacob Patijn, Maarten van Kleef
The cervical facet joints, also called the zygapophyseal joints, are a potential source of neck pain (cervical facet joint pain). The cervical facet joints are innervated by the cervical medial branches (CMBs) of the cervical segmental nerves. Cervical facet joint pain has been shown to respond to multisegmental radiofrequency denervation of the cervical medial branches. This procedure is performed under fluoroscopic guidance. Currently, three approaches are described and used. Those three techniques of radiofrequency treatment of the CMBs, classified on the base of the needle trajectory toward the anatomical planes, are as follows: the posterolateral technique, the posterior technique, and the lateral technique...
October 13, 2016: Pain Practice: the Official Journal of World Institute of Pain
Wael Mohamed Mohamed Moussa, Wael Khedr
OBJECTIVES: Percutaneous radiofrequency denervation of the medial dorsal branch is often used in chronic low back pain of intervertebral facet etiology, which is sometimes difficult to perform and recurrence of pain often ensues. We theorized that shifting the target of RF coagulation to the facet joint capsule would provide an easier target and a longer-lived pain relieving response. PATIENTS AND METHODS: A prospective randomized controlled trial where 120 patients diagnosed with CLBP of a confirmed facet origin were randomly divided into three equal groups, the first was submitted to percutaneous radiofrequency coagulation of the facet joint capsule, the second underwent percuataneous denervation of the medial dorsal branch and the third did not receive radiofrequency lesioning...
November 2016: Clinical Neurology and Neurosurgery
Vinay S Anjana Reddy, Chhaya Sharma, Kuang-Yi Chang, Vivek Mehta
BACKGROUND: Sacroiliac joint (SIJ) pain is considered to be the third most common cause of low back pain with the prevalence of 13-25% in all low back pain patients. Its diagnosis and treatment remain a challenge with the poor evidence base for interventional procedures. Patients with SIJ pain experience a low quality of life, worse than some of the chronic health conditions. Simplicity radiofrequency (RF) neurotomy is a novel technique which tackles some of the problems faced by conventional RF neurotomy and may offer better results in managing pain arising from SIJ...
May 2016: British Journal of Pain
Bhanu Prasad, Shelley Giebel, Francisco Garcia, Kunal Goyal, Jennifer Rose St Onge
Loin pain hematuria syndrome (LPHS) is a painful and incapacitating condition that typically affects young women. Treatment options, including opiates and/or surgical denervation of the renal nerves by autotransplantation, have variable success. In this report, we describe the successful use of endovascular renal nerve ablation in this population. Four women with LPHS and intractable pain unresponsive to conservative measures underwent endovascular ablation of the renal nerves between July and November 2015 using the Vessix renal denervation system...
August 12, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Qin Zhou, Fang Zhou, Long Wang, Kang Liu
OBJECTIVES: This study aims to observe the clinical efficacy and feasibility of improved X-rays-guided radiofrequency thermocoagulation denervation for treating low back pain secondary to lumbar facet joint syndrome (LFJS). PATIENTS AND METHODS: Eighty LFJS patients were randomly assigned into two groups: the denervation group (n=40), treated with percutaneous radiofrequency thermocoagulation denervation on the lumbar facet joint, and the control group (n=40), injected with betamethasone and lidocaine into the lumbar facet joint...
September 2016: Clinical Neurology and Neurosurgery
J Fleisch, A Dahan
Pain from the sacroiliac (SI) joint is, along with osteoarthritis of the facet joints, one of the main sources of mechanical low back pain. Here we discuss the negative results of two recent randomized controlled trials in the Netherlands on the use of radiofrequency (RF) denervation to treat low back pain arising from the SI joint. Possible causes of treatment failure are discussed. The authors also discuss the use of an intra-articular injection of the combination of a local anaesthetic and a glucocorticoid as an alternative to RF denervation...
2016: Nederlands Tijdschrift Voor Geneeskunde
Jorge F Ramirez Leon, Jose G Rugeles Ortiz, Enrique Osorio Fonseca, Carolina Ramirez Martinez, Gabriel Oswaldo Alonso Cuellar
BACKGROUND: Zygapophysial joint arthrosis is a pathology related with axial lumbar pain. The most accepted treatment, after failure of medical management, is the thermal denervation of the medial branch. Nonetheless, the placement of the heat probe remains a challenge to surgeons, even when using the fluoroscope. Using a variation of Shealy's and Bogduk's original techniques, which includes ablation of the medial branch and the nerves present in the joint capsule, we hypothesize that we can obtain similar outcomes to those found in the literature...
March 2016: Pain Physician
Martina Bellini, Massimo Barbieri
BACKGROUND: Sacroiliac joint pain can be managed by intra-articular injections or radiofrequency of its innervation. Single strip lesions radiofrequency denervation is a new system. The objective of this study was to present one of the first utilizations of this innovative technique. METHODS: 60 patients who met the diagnostic criteria for sacroiliac joint syndrome were enrolled in the study. In total, 102 single strip lesions radiofrequency denervations were performed...
2016: Anaesthesiology Intensive Therapy
Joseph M Pirolo, Wei Le, Jeffrey Yao
PURPOSE: To evaluate the effect of thermal treatment on neural tissue in the triangular fibrocartilage complex (TFCC), scapholunate interosseous ligament (SLIL), and lunotriquetral interosseous ligament (LTIL). METHODS: The intact TFCC, SLIL, and LTIL were harvested from cadaveric specimens and treated with a radiofrequency probe as would be performed intraoperatively. Slides were stained using a triple-stain technique for neurotrophin receptor p75, pan-neuronal marker protein gene product 9...
May 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Dae Seok Oh, Tae Hyung Kang, Hyae Jin Kim
Lateral epicondylitis is a painful and functionally limiting disorder. Although lateral elbow pain is generally self-limiting, in a minority of people symptoms persist for a long time. When various conservative treatments fail, surgical approach is recommended. Surgical denervation of several nerves that innervate the lateral humeral epicondyle could be considered in patients with refractory pain because it denervates the region of pain. Pulsed radiofrequency is a minimally invasive procedure that improves chronic pain when applied to various neural tissues without causing any significant destruction and painful complication...
June 2016: Journal of Anesthesia
Ralph F Rashbaum, Donna D Ohnmeiss, Emily M Lindley, Scott H Kitchel, Vikas V Patel
The sacroiliac joint (SIJ) as a source of symptoms has been controversial; however, as knowledge about the joint increased, its role as a pain generator in patients complaining of symptoms that are often attributed to spinal pathology has become better appreciated. The literature reports that the SIJ is the pain origin in as many as 30% of patients presenting with low back pain. Clinically, the SIJ can be challenging to evaluate; however, assessing pain location, patient posture/movement, and provocative manual testing are useful in making the presumptive diagnosis of SIJ disruption...
March 2016: Clinical Spine Surgery
Peter D Counsel, Marcus Davenport, Angus Brown, Chin Chin Ooi, Jules Comin, Paul Marks, David A Connell
OBJECTIVE: Plantar fasciosis is a common complaint of athletes, particularly for runners. The medial calcaneal nerve (MCN) may play a role in the pain syndrome, and radiofrequency (RF) denervation has been previously reported. The hypothesis is that ultrasound-guided denervation of the MCN results in symptomatic improvement. DESIGN: Retrospective cohort. SETTING: Private practice. PATIENTS: Twenty-nine patients previously receiving ultrasound-guided RF denervation of the MCN, having failed conservative therapy, were assessed in 2 groups, those more than (group 1, n = 16) or less than (group 2, n = 13) 6 months since the procedure...
February 10, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Eun Ji Choi, Yun Mi Choi, Eun Jung Jang, Ju Yeon Kim, Tae Kyun Kim, Kyung Hoon Kim
A nerve block is an effective tool for diagnostic and therapeutic methods. If a diagnostic nerve block is successful for pain relief and the subsequent therapeutic nerve block is effective for only a limited duration, the next step that should be considered is a nerve ablation or modulation. The nerve ablation causes iatrogenic neural degeneration aiming only for sensory or sympathetic denervation without motor deficits. Nerve ablation produces the interruption of axonal continuity, degeneration of nerve fibers distal to the lesion (Wallerian degeneration), and the eventual death of axotomized neurons...
January 2016: Korean Journal of Pain
W Michael Hooten, Steven P Cohen
Low back pain (LBP) is a leading cause of disability worldwide. In the absence of a classification system for pain syndromes, classification of LBP on the basis of the distribution of pain as axial (pain generally localized to the low back) or radicular neuropathic (pain radiating to the lower extremities) is relevant to clinical practice because the distribution of pain is often a corollary of frequently occurring disease processes involving the lumbar spine. Common sources of axial LBP include the intervertebral disc, facet joint, sacroiliac joint, and paraspinal musculature, whereas common sources of radicular pain include a herniated intervertebral disc and spinal stenosis...
December 2015: Mayo Clinic Proceedings
Frans Van de Perck, Filiep Soetens, Christophe Lebrun, Arno Lataster, Amaury Verhamme, Jan Van Zundert
Radiofrequency denervation of the cervical medial branches is a possible treatment for chronic cervical facet pain syndrome when conservative management has failed. According to the literature, complications after radiofrequency denervation of the cervical medial branches are rare. We report a case of possible phrenic nerve injury after ipsilateral radiofrequency denervation of the cervical medial branches following a posterolateral approach.
February 2016: Pain Practice: the Official Journal of World Institute of Pain
Matthias Ringkamp, Matthew Wooten, Benjamin S Carson, Michael Lim, Timothy Hartke, Michael Guarnieri
OBJECTIVE: Percutaneous treatments for trigeminal neuralgia are safe, simple, and effective for achieving good pain control. Procedural risks could be minimized by using noninvasive imaging techniques to improve the placement of the radiofrequency thermocoagulation probe into the trigeminal ganglion. Positioning of a probe is crucial to maximize pain relief and to minimize unwanted side effects, such as denervation in unaffected areas. This investigation examined the use of laser speckle imaging during probe placement in an animal model...
February 2016: Journal of Neurosurgery
Flávio Ramalho Romero, Roberto Bezerra Vital, Marco Antônio Zanini, Luis Gustavo Ducati, Roberto Colichio Gabarra
Sacroiliac joint (SIJ) pain is responsible for up to 40% of all cases of lumbar back pain. Objective Report the long-term efficacy of radiofrequency denervation for sacroiliac joint pain at six, twelve and eighteen months.Method Third-two adults' patients with sacroiliac join pain diagnosis were included for a prospective study. Primary outcome measure was pain intensity on the Numeric Rating Scale (NRS). Secondary outcome measure was Patient Global Impression of Change Scale (PGIC).Results Short-term pain relief was observed, with the mean NRS pain score decreasing from 7...
June 2015: Arquivos de Neuro-psiquiatria
Steven P Cohen, Jee Youn Moon, Chad M Brummett, Ronald L White, Thomas M Larkin
BACKGROUND: Medial branch blocks (MBBs) and intra-articular (IA) facet joint injections are both used to diagnose facet joint pain and are presumed to be equivalent. No study has sought to determine which has a better prognostic value before radiofrequency (RF) denervation. METHODS: A case-control study was performed at 4 institutions in which RF denervation outcomes in patients who obtained 50% or more pain relief from either MBB (n = 212) or IA injections (n = 212) were compared...
July 2015: Regional Anesthesia and Pain Medicine
Martina Bellini, Massimo Barbieri
BACKGROUND: Knee osteoarthritis is a frequent cause of chronic knee pain. Therapeutic solutions include intra-articular injections with short-term pain relief and surgical therapy. Radiofrequency (RF) of genicular nerves has been previously reported with varying success. Cooling tissue adjacent to the electrode (cooled RF) increases the radius of lesion. We present here the first retrospective data on pain relief and changes in function after such cooled RF denervation. METHODS: We reviewed the records of nine patients with chronic knee pain who underwent cooled RF of genicular nerves...
2015: Anaesthesiology Intensive Therapy
Steven P Cohen
Neck pain is the fourth leading cause of disability, with an annual prevalence rate exceeding 30%. Most episodes of acute neck pain will resolve with or without treatment, but nearly 50% of individuals will continue to experience some degree of pain or frequent occurrences. History and physical examination can provide important clues as to whether the pain is neuropathic or mechanical and can also be used to identify "red flags" that may signify serious pathology, such as myelopathy, atlantoaxial subluxation, and metastases...
February 2015: Mayo Clinic Proceedings
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