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Radiofrequency neurotomy

Laxmaiah Manchikanti, Vidyasagar Pampati, Alan D Kaye, Joshua A Hirsch
Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions...
2017: International Journal of Medical Sciences
Alison Stout, Paul Dreyfuss, Nathan Swain, Shannon Roberts, Eldon Loh, Anne Agur
Background: Current sacroiliac joint (SIJ) cooled radiofrequency (RF) is based on fluoroscopic anatomy of lateral branches (LBs) in three specimens. Recent studies confirm significant variation in LB positions. Objectives: To determine if common fluoroscopic needle placements for cooled SIJ RF are adequate to lesion all S1-3 LBs. If not, would different targets improve lesion accuracy? Methods: The LBs of 20 cadavers were dissected bilaterally (40 SIJs), and 26 G radiopaque wires were sutured to the LBs...
November 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Liza Hernández-González, Carlos E Calvo, David Atkins-González
Intra-articular hip and knee pain is a common cause of physical and psychosocial disability. Many conservative treatment options provide only short-term relief. Recent research studies have shown improvement in pain and function with minimal complications after radiofrequency neurotomy of the hip and the knee, especially in patients who have failed conservative treatment or are not surgical candidates. More quality research studies are needed to establish the efficacy and safety of these procedures in patients with refractory hip and knee pain...
February 2018: Physical Medicine and Rehabilitation Clinics of North America
Jae Chul Koh, Do Hyeong Kim, Youn Woo Lee, Jong Bum Choi, Dong Hun Ha, Ji Won An
Background: To achieve a prolonged therapeutic effect in patients with lumbar facet joint syndrome, radiofrequency medial branch neurotomy (RF-MB) is commonly performed. The purpose of this study was to evaluate the prognostic value of paravertebral muscle twitching when performing RF-MB in patients with lumbar facet joint syndrome. Methods: We collected and analyzed data from 68 patients with confirmed facet joint syndrome. Sensory stimulation was performed at 50 Hz with a 0...
October 2017: Korean Journal of Pain
John MacVicar, D Scott Kreiner, Belinda Duszynski, David J Kennedy
Objective: To provide an overview of a multisociety effort to formulate appropriate use criteria for image-guided injections and radiofrequency procedures in the diagnosis and treatment of sacroiliac joint and posterior sacroiliac complex pain. Methods: The Spine Intervention Society convened a multisociety effort to guide physicians and define for payers the appropriate use of image-guided injections and radiofrequency procedures. An evidence panel was established to write systematic reviews, define key terms and assumptions, and develop clinical scenarios to be addressed...
November 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Gokhan Kuyumcu, Murali Sundaram, Jean P Schils, Hakan Ilaslan
Osteoid osteoma is a common benign tumor that is typically found in young adults and children, usually in the long bones of the lower extremity. Radiofrequency ablation (RFA) under computed tomography guidance is the standard of care for symptomatic osteoid osteomas. However, patients with osteoid osteoma of the hand or foot are often treated with open surgery because of the risk of injury to vascular and neural structures from RFA. This risk is more pronounced in pediatric patients because of the small lesion size and proximity of lesions to important neurovascular structures...
November 2017: Skeletal Radiology
Dong Gyu Lee, Sang Ho Ahn, Yun Woo Cho, Kyung Hee Do, Sang Gyu Kwak, Min Cheol Chang
STUDY DESIGN: A prospective observational study. OBJECTIVE: The aim of this study was to show the effect of intra-articular (IA) thoracic facet joint (TFJ) steroid injection for the management of TFJ pain, and to compare it with the effect of therapeutic thoracic medial branch block (MBB) with a local anesthetic and steroid. SUMMARY OF BACKGROUND DATA: Several studies have shown the effects of thoracic MBB with local anesthetics with or without steroids and radiofrequency neurotomy in managing TFJ pain, but thus far, the effectiveness of IA TFJ steroid injection has not been studied...
January 15, 2018: Spine
Tyler J Christensen, M Scott DeBerard, Anthony J Wheeler
PURPOSE: The prevalence of radiofrequency zygapophyseal joint neurotomy (RFN) has increased substantially across the past decade. Limited research exists that has examined pre-procedure predictors of RFN outcomes, particularly within workers' compensation populations. The purpose of this study was to determine if pre-procedure biopsychosocial variables are predictive of outcomes in a cohort of compensated Utah patients who have undergone RFN. PATIENTS AND METHODS: This was a retrospective cohort study consisting of a review of pre-procedure medical records and a telephone outcome survey...
2017: Journal of Pain Research
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting: Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective: To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
July 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
V Miccio, J Singh, J Bonder, R Navlani
No abstract text is available yet for this article.
April 2016: Journal of Pain: Official Journal of the American Pain Society
Charles A Odonkor, Teresa Tang, David Taftian, Akhil Chhatre
Introduction. Cervicogenic headache is characterized by unilateral neck or face pain referred from various structures such as the cervical joints and intervertebral disks. A recent study of patients with cervical pain showed significant pain relief after cervical medial branch neurotomy but excluded patients with C1-2 joint pain. It remains unclear whether targeting this joint has potential for symptomatic relief. To address this issue, we present a case report of C1-2 joint ablation with positive outcomes...
2017: Case Reports in Anesthesiology
Wolfgang Stelzer, Valentin Stelzer, Dominik Stelzer, Monika Braune, Christine Duller
PURPOSE: This retrospective original research was designed to illustrate the general outcome after radiofrequency (RF) neurotomy of lumbar medial branch (MB) and posterior ramus of the sacroiliac joint of 160 patients with chronic low back pain (LBP) 1, 6, and 12 months after treatment. METHODS: Visual Analog Scale (VAS) 0-10 pain scores, quality of life, body mass index (BMI), medication usage, and frequency of physical exercise/sports participation (none, 1-3×/week, more) were collected before the procedure, at 1 month post procedure (n=160), and again at 6 (n=73) and 12 months (n=89) post procedure...
2017: Journal of Pain Research
María M Santana Pineda, Luc E Vanlinthout, Ana Moreno Martín, Jan van Zundert, Fernando Rodriguez Huertas, José P Novalbos Ruiz
BACKGROUND AND OBJECTIVES: Radiofrequency ablation of genicular nerves has proved to be successful in relieving pain and incapacity caused by osteoarthritis of the knee. However, long-term efficacy of such a treatment remains to be assessed. The current study aimed to reproduce radiofrequency neurotomy of genicular nerves to manage gonarthrosis pain and disability and establish therapeutic response until 1 year after intervention. METHODS: This single-center, prospective, observational, noncontrolled, longitudinal study included patients with grade 3 to 4 gonarthrosis suffering from intractable knee pain, scoring 5 or more on the visual analog scale (VAS) during >6 months...
January 2017: Regional Anesthesia and Pain Medicine
Roderick J Finlayson, Atikun Thonnagith, Maria Francisca Elgueta, Jordi Perez, John-Paul B Etheridge, De Q H Tran
BACKGROUND AND OBJECTIVES: Novel multitined cannulae constitute an attractive option for ultrasound-guided radiofrequency neurotomy of cervical medial branches. The deployment tines increase the cannula's active area, thus altering its lesion size. Despite their theoretical benefits, multitined cannulae have not been assessed. In this bench study, we sought to investigate the lesions produced by a standard 18-gauge and 2 commercially available multitined deployment cannulae. We created ex vivo models to evaluate lesion morphology at a periosteal interface using approach angles likely to be encountered during an ultrasound-guided technique...
January 2017: Regional Anesthesia and Pain Medicine
Vincent F Miccio, Rohit Navlani, Jaclyn H Bonder, Jaspal Ricky Singh
No abstract text is available yet for this article.
September 2016: Pain Physician
David Arsanious, Emmanuel Gage, Jonathon Koning, Mazin Sarhan, Gassan Chaiban, Mohammed Almualim, Joseph Atallah
BACKGROUND: One of the potential side effects with radiofrequency ablation (RFA) includes painful cutaneous dysesthesias and increased pain due to neuritis or neurogenic inflammation. This pain may require the prescription of opioids or non-opioid analgesics to control post-procedural pain and discomfort. OBJECTIVES: The goal of this study is to compare post-procedural pain scores and post-procedural oral analgesic use in patients receiving continuous thermal radiofrequency ablation versus patients receiving pulsed dose radiofrequency immediately followed by continuous thermal radiofrequency ablation for zygopophaseal joint disease...
September 2016: Pain Physician
Michael E Farrell, Genaro Gutierrez, Mehul J Desai
This case presentation demonstrates radiographic evidence of lesions created following cooled radiofrequency (cRF) neurotomy of the knee. A 67-year-old man presented with chronic left knee osteoarthritis, pain, and disability. After a failed trial of conservative treatments, the patient underwent diagnostic genicular nerve blocks and subsequent cRF neurotomy, of the left knee. Shortly after cRF, magnetic resonance imaging (MRI) of the left knee was performed. On MRI, lesions created by cRF ablation were identified...
September 14, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Michele Curatolo
Synopsis Whiplash-associated disorder (WAD) is a group of symptoms and clinical manifestations resulting from rear-end or side impact. Despite the wide use of medications in WAD, the published research does not allow recommendations based on high evidence level. It may be meaningful to use nonsteroidal anti-inflammatory drugs in the acute posttraumatic phase. In chronic WAD, the use of nonsteroidal anti-inflammatory drugs is more concerning due to potential gastrointestinal and renal complications with prolonged use and lack of evidence for long-term benefits...
October 2016: Journal of Orthopaedic and Sports Physical Therapy
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
Sinem Sarı, Osman N Aydın, Yasemin Turan, Pınar Özlülerden, Ufuk Efe, İmran Kurt Ömürlü
OBJECTIVES: To compare the efficacy of intra-articular injection and radiofrequency (RF) neurotomy of genicular nerves in patients with chronic knee osteoarthritis (OA) pain. METHODS: Seventy-three patients with knee OA were included in the study. Patients were randomly assigned to Group IA (intra-articular 2.5 mL of bupivacaine, 2.5 mg of morphine and 1 mL of betamethasone, 6 mL of fluid injection) or Group RF (RF neurotomy of the genicular nerves). The outcome measures included a pain scale (visual analog scale, VAS) and Western Ontario and McMaster Universities (WOMAC) Index of Osteoarthritis...
August 12, 2016: International Journal of Rheumatic Diseases
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