Pulsed Radiofrequency in the Treatment of Patients with Chronic Neuropathic Spinal Pain
18 July 2006 (online)
In recent years there has been debate among spinal surgeons, neurosurgeons and pain physicians regarding the efficacy of radiofrequency (RF) ablation when treating patients with a neuropathic pain source. It is usually considered as a treatment option after conservative treatment has failed. Twenty-eight patients with a minimal follow-up of 1 year were examined in our institution after they had undergone pulsed radiofrequency (PRF) procedures due to neuropathic spinal pain. Nineteen patients (68 %) reported long-term pain relief (more than 1 year) which was defined as a reduction of the visual analogue score by at least 30 %. No complications were found in this study except for mild discomfort in the treated area which spontaneously resolved up to 3 weeks after the procedure. We concluded that PRF is a safe and an effective procedure for patients who suffer from chronic neuropathic pain from spinal origin. It should be tried after conservative treatment has failed.
Pulsed radiofrequency - neuropathic spinal pain
- 1 Hecht P, Hayashi K, Lu Y, Fanton G S, Thabit 3rd G, Vanderby Jr R, Markel M D. Monopolar radiofrequency energy effects on joint capsular tissue: potential treatment for joint instability. An in vivo mechanical, morphological, and biochemical study using an ovine model. Am J Sports Med. 1999; 27 761-771
- 2 Munglani R. The longer-term effect of pulsed radiofrequency for neuropathic pain. Pain. 1999; 80 437-439
- 3 Pockett S. Spinal cord synaptic plasticity and chronic pain. Anesth Analg. 1995; 80 173-179
- 4 Sandkuhler J, Chen J G, Cheng G, Randic M. Low-frequency stimulation of afferent Adelta-fibers induced long-term depression at primary afferent synapses with substancia gelatinosa neurones in the rat. J Neurosci. 1997; 17 6483-6491
- 5 Patt R B, Cousins M J. Techniques for neurolytic blockade. In: Cousins MJ, Bridenbaugh (Eds.). Neural Blockade, third edition. Philadelphia: Lippencott Raven 1998: 1007-1062
- 6 Wijk R M Van, Geurts J W, Wynne H J. Long-lasting analgesic effect of radiofrequency treatment of the lumbosacral dorsal root ganglion. J Neurosurg. 2001; 94 227-231
- 7 Yin Y, Willard F, Carreiro J, Dreyfuss P. Sensory stimulation-guided sacroiliac joint radiofrequency neurotomy: technique based on neuroanatomy of the dorsal sacral plexus. Spine. 2003; 28 2419-2425
- 8 Kleef M van, Barendse G A, Kessels A H, Lousberg R, Sluijer M. Radiofrequency lesion adjacent to the dorsal root ganglion for cervical pain: a prospective double blind randomized study. Neurosurgery. 1996; 38 1127-1132
- 9 Borenstein D G. Epidemiology, etiology, diagnostic evaluation, and treatment of low back pain. Curr Opin Rheumatol. 1999; 11 151-157
- 10 Farrar J T, Young Jr J P, LaMoreaux L, Werth J L, Poole R M. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001; 94 149-158
- 11 Bowsher D. Mechanics of acupuncture. In: Filshie J, White A (Eds.). Medical Acupuncture. Edinburgh: Churchill Livingstone 1998: 69-82
- 12 Slappendel R, Crul B J, Braak G J, Geurts J W, Booij L H, Voerman V F, do Boo T. The efficacy of radiofrequency lesioning of the cervical dorsal root ganglion in a double-blind randomized study: no difference between 40 and 67 °C treatments. Pain. 1997; 73 159-163
- 13 North R B, Han M, Zahurak M, Kidd D H. Radiofrequency lumbar facet denervation: analysis of prognostic factors. Pain. 1994; 57 77-83
- 14 Sapir D A, Gorup J M. Radiofrequency medial branch neurotomy in litigant and nonlitigant patients with cervical whiplash: a prospective study. Spine. 2001; 26 268-273
Shay Shabat, , M. D.
Spinal Care Unit · Sapir Medical Center
48 Tchernichovsky St.