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Radiofrequency neurotomy

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
Hae Min Jo, Hyo Sung Kim, Yun-Woo Cho, Sang-Ho Ahn
BACKGROUND: Little research has been expended on the use of bipolar radiofrequency (RF) lesioning of sacral nerves in spinal cord injured (SCI) patients with neurogenic detrusor overactivity (NDO), and no study has been undertaken to demonstrate its long-term effect. OBJECTIVE: To investigated the effect of bipolar RF ablation of the second and third sacral nerves over 2 years in SCI patients with NDO. STUDY DESIGN: A prospective, randomized controlled feasibility study...
July 2016: Pain Physician
Elena A Kaye, Sebastien Monette, Govindarajan Srimathveeravalli, Majid Maybody, Stephen B Solomon, Amitabh Gulati
PURPOSE: About 10-40% of chronic low back pain cases involve facet joints, which are commonly treated with lumbar medial branch (MB) radiofrequency neurotomy. Magnetic resonance imaging-guided focused ultrasound (MRgFUS), a non-invasive, non-ionising ablation modality used to treat tumours, neuropathic pain and painful bone metastasis can also be used to disrupt nerve conduction. This work's purpose was to study the feasibility and safety of direct MRgFUS ablation of the lumbar MB nerve in acute and subacute swine models...
November 2016: International Journal of Hyperthermia
Haibin Wang, Eric R Helm, Herbie Yung
STUDY DESIGN: non -randomized trial OBJECTIVE.: This is an ex vivo study using pork chops to simulate human vertebra to determine the effects of various anesthetic fluids injectates and concentrations on lesion size and shape created when using cooled radiofrequency ablation. Secondary objective is to determine the effects of various time durations of applied lesion on lesion size created. Our final objective is to determine the effects of fluid injectates on tissue temperature and impedance...
June 15, 2016: Spine
Jinyoung Oh, Daehyun Jo, Koohyun Kim, Jungwoo Shim, Misun Roh
UNLABELLED: Lumbar spinal stenosis is one of most common pathologic conditions affecting the lumbar spine. Pain and/or disability in the low back and lower extremities with or without neurogenic claudication may occur as a result of compression of dural sac contents or nerve roots in the narrowed space. Bulging and protrusion, facet joint hypertrophy, and disc herniation combined with osteophytes and arthritic changes of facet joints can be the cause of lumbar spinal stenosis. Medical/interventional treatment may be considered as an initial treatment for patients with mild symptoms of lumbar spinal stenosis...
May 2016: Pain Physician
Laxmaiah Manchikanti, Joshua A Hirsch, Frank Je Falco, Mark V Boswell
AIM: To investigate the diagnostic validity and therapeutic value of lumbar facet joint interventions in managing chronic low back pain. METHODS: The review process applied systematic evidence-based assessment methodology of controlled trials of diagnostic validity and randomized controlled trials of therapeutic efficacy. Inclusion criteria encompassed all facet joint interventions performed in a controlled fashion. The pain relief of greater than 50% was the outcome measure for diagnostic accuracy assessment of the controlled studies with ability to perform previously painful movements, whereas, for randomized controlled therapeutic efficacy studies, the primary outcome was significant pain relief and the secondary outcome was a positive change in functional status...
May 18, 2016: World Journal of Orthopedics
Alexander Bautista, Alisher Dadabayev, Ellen Rosenquist, Jianguo Cheng
We report 2 cases of successful treatment of neck and back pain with bipolar radiofrequency ablation (RFA) of the cervical and lumbar facet joints in patients with an automatic implantable cardioverter defibrillator (AICD).Two patients with complex cardiac histories and AICD devices were treated with bipolar RFA of the facet joints. One presented with axial neck pain and the other with axial back pain. The histories and physical examinations were consistent with facetogenic pain. Diagnostic medial branch block resulted in more than 70% pain relief lasting for several days, allowing patients to perform routine daily activities without significant pain...
March 2016: Pain Physician
Sara Christensen Holz, Nalini Sehgal
BACKGROUND: Facet joint pain is a common cause of low back pain. There are no physical exam findings that provide a reliable diagnosis. Diagnosis is made by medial branch block injections (MBB). Once the source of pain has been determined, radiofrequency neurotomy (RFN) can be performed. Previous studies have shown that RFN reduces level of pain and improves function. No study has tried to correlate MBB results with outcomes after RFN. OBJECTIVES: (1) Estimate percentage decrease in pain, decrease in analgesic use, and increase in activity tolerance after facet joint radiofrequency neurotomy (2) Determine correlation between percentage pain relief or duration of pain relief after MBB and RFN outcomes...
March 2016: Pain Physician
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
Richard Salzman, Tomáš Gabrhelík, Ivo Stárek
Superior laryngeal (SL) neuralgia is paroxysmal pain above the thyrohyoid membrane. We present a case of SL neuralgia that was resistant to conservative treatment and eventually required surgical intervention. The patient was a 39-year-old woman with a 5-year history of debilitating pain above the thyroid cartilage. After having undergone different imaging scans with negative results, she tried various treatments (e.g., antibiotics, analgesics, stellate ganglion block, radiofrequency SL neurotomy, and stereotactic radiosurgery), all of which were ineffective...
March 2016: Ear, Nose, & Throat Journal
Laxmaiah Manchikanti, Joshua A Hirsch, Alan D Kaye, Mark V Boswell
Diagnostic facet joint nerve blocks have been utilized in the diagnosis of cervical facet joint pain in patients without disk herniation or radicular pain due to a lack of reliable noninvasive diagnostic measures. Therapeutic interventions include intra-articular injections, facet joint nerve blocks and radiofrequency neurotomy. The diagnostic accuracy and effectiveness of facet joint interventions have been assessed in multiple diagnostic accuracy studies, randomized controlled trials (RCTs), and systematic reviews in managing chronic neck pain...
January 2016: Postgraduate Medicine
Prempreet S Bajaj, Jonathan Napolitano, Wenbao Wang, Jianguo Cheng, Jaspal Ricky Singh
No abstract text is available yet for this article.
October 2015: PM & R: the Journal of Injury, Function, and Rehabilitation
Shrif Costandi, Mauricio Garcia-Jacques, Teresa Dews, Michael Kot, Kevin Wong, Gerges Azer, Jasmyn Atalla, Michael Looka, Elie Nasr, Nagy Mekhail
BACKGROUND: Radiofrequency ablation (RFA) of the medial branch nerves that innervate the facet joints is a well-established treatment modality; however, studies to determine the optimal radiofrequency ablation temperature are lacking. A wide range (70 to 90°C) has been used. This study aimed to compare outcomes with two set temperatures for the lumbar facet medial branch ablation, 90 and 80°C. METHODS: This retrospective study compared the degree of patient self-reported functional improvement relief, postoperative opioid dose changes, as well as duration among lumbar facet medial branch (RFA) patients who had the procedures performed at 80 or 90°C...
September 15, 2015: Pain Practice: the Official Journal of World Institute of Pain
Andrew Engel, George Rappard, Wade King, David J Kennedy
OBJECTIVE: To determine the effectiveness and risks of fluoroscopically-guided cervical medial branch thermal radiofrequency neurotomy (CMBTRFN) for treating chronic neck pain of zygapophysial joint origin. DESIGN: Systematic review of the literature with comprehensive analysis of the published data. INTERVENTIONS: Four reviewers formally trained in evidence-based medicine searched the literature on CMBTRFN. Each assessed the methodologies of studies found and appraised the quality of evidence presented...
April 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Laxmaiah Manchikanti, Alan D Kaye, Mark V Boswell, Sanjay Bakshi, Christopher G Gharibo, Vahid Grami, Jay S Grider, Sanjeeva Gupta, Sachin Sunny Jha, Dharam P Mann, Devi E Nampiaparampil, Manohar Lal Sharma, Lindsay N Shroyer, Vijay Singh, Amol Soin, Ricardo Vallejo, Bradley W Wargo, Joshua A Hirsch
BACKGROUND: The therapeutic spinal facet joint interventions generally used for the treatment of axial spinal pain of facet joint origin are intraarticular facet joint injections, facet joint nerve blocks, and radiofrequency neurotomy. Despite interventional procedures being common as treatment strategies for facet joint pathology, there is a paucity of literature investigating these therapeutic approaches. Systematic reviews assessing the effectiveness of various therapeutic facet joint interventions have shown there to be variable evidence based on the region and the modality of treatment utilized...
July 2015: Pain Physician
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