Effect of pulsed radiofrequency for postherpetic neuralgia

Kim, Y. H.; Lee, C. J.; Lee, S. C.; Huh, Jin Young; Nahm, Francis Sahngun; Kim, H. Z.; Lee, M. K.

doi:10.1111/j.1399-6576.2008.01752.x

Cited by 51 publications

(37 citation statements)

References 9 publications

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“…Post-procedure pain scores and tramadol use were decreased, and several health-related quality of life domains were significantly improved through 6 months after treatment in the PRF group compared to the sham group. These results are similar to the reports from open-label studies of a reduction in pain during a 12-week follow up period after PRF treatment of the affected cervical, thoracic, or lumbar DRG in patients with PHN [67]. No complications were encountered in these studies.…”

Section: Peripheral Np Conditionssupporting

confidence: 89%

Interventional management of neuropathic pain: NeuPSIG recommendations

Dworkin

O’Connor

Kent

et al. 2013

Pain

377

288

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Neuropathic pain (NP) is often refractory to pharmacologic and non-interventional treatment. On behalf of the International Association for the Study of Pain Neuropathic Pain Special Interest Group (NeuPSIG), the authors evaluated systematic reviews, clinical trials, and existing guidelines for the interventional management of NP. Evidence is summarized and presented for neural blockade, spinal cord stimulation (SCS), intrathecal medication, and neurosurgical interventions in patients with the following peripheral and central NP conditions: herpes zoster and postherpetic neuralgia (PHN); painful diabetic and other peripheral neuropathies; spinal cord injury NP; central post-stroke pain; radiculopathy and failed back surgery syndrome (FBSS); complex regional pain syndrome (CRPS); and trigeminal neuralgia and neuropathy. Due to the paucity of high-quality clinical trials, no strong recommendations can be made. Four weak recommendations based on the amount and consistency of evidence, including degree of efficacy and safety, are: (1) epidural injections for herpes zoster; (2) steroid injections for radiculopathy; (3) SCS for FBSS; and (4) SCS for CRPS type 1. Based on the available data, we recommend not to use sympathetic blocks for PHN nor RF lesions for radiculopathy. No other conclusive recommendations can be made due to the poor quality of available of data. Whenever possible, these interventions should either be part of randomized clinical trials or documented in pain registries. Priorities for future research include randomized clinical trials; long-term studies; and head-to-head comparisons among different interventional and non-interventional treatments.

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Section: Peripheral Np Conditionssupporting

confidence: 89%

Interventional management of neuropathic pain: NeuPSIG recommendations

Dworkin

O’Connor

Kent

et al. 2013

Pain

377

288

View full text Add to dashboard Cite

show abstract

“…Moreover, DRG radiofrequency lesions seem to perform well without any associated complications; however, the mean follow-up of the studies was only 3.5 months which limited the capacity to detect chronic complications [39, 40]. Our results demonstrate that peripheral nerve stimulation and SCS achieved an average of 76.5 and 64.4% pain reduction; those two procedures are less invasive among neurosurgical options, show promising results and are generally safe.…”

Section: Discussionmentioning

confidence: 72%

“…One study reported a mean reduction of the morphine equivalent dose from 35.2 mg before to 20 mg after the procedure [40]. The study by Kim et al [39] documented that 3/49 (6.1%) patients discontinued all analgesic medication while the rest reduced the dose or maintained it to the pre-procedural levels.…”

Section: Resultsmentioning

confidence: 99%

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Neurosurgeons’ Armamentarium for the Management of Refractory Postherpetic Neuralgia: A Systematic Literature Review

Texakalidis

Tora

Boulis

2019

Stereotact Funct Neurosurg

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Background/Aims: Postherpetic neuralgia (PHN) can be refractory to both medical and minimally invasive treatments. Its complex pathophysiology explains the numerous neurosurgical procedures that have been implemented through the years. Our objective was to summarize all available neurosurgical strategies for the management of resistant PHN and evaluate their respective safety and efficacy outcomes. Methods: A comprehensive systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: A total of 38 studies comprising 811 patients with refractory PHN were included. The safety and efficacy of the following procedures were investigated: spinal cord stimulation (SCS), dorsal root entry zone (DREZ) lesioning, intrathecal drug delivery, caudalis DREZ lesioning, dorsal root ganglion (DRG) radiofrequency lesioning, peripheral nerve stimulation, gamma knife surgery, deep brain stimulation, cordotomy, percutaneous radiofrequency rhizotomy and Gasserian ganglion stimulation. Conclusions: There are several available neurosurgical approaches for recalcitrant PHN including neuromodulatory and ablative procedures. It is suggested that patients with resistant PHN undergo minimally invasive procedures first, including SCS, peripheral nerve stimulation or DRG radiofrequency lesioning. More invasive procedures should be reserved for refractory cases. Comparative studies are needed in order to construct a PHN neurosurgical management algorithm.

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“…117 Pulsed radio-frequency lesioning of the DRG has been assessed in an open case series, and did show some benefit; however, as with most interventions, a study designed to account for the placebo effect is required. 118 Use of lidocaine and methylprednisolone combined (via intrathecal administration) appears to be associated with pain relief in PHN patients, 119 although this has potentially dangerous short-term and long-term adverse effects and the trial has not yet been replicated. 79 Spinal cord stimulation has been used for the treatment of neuropathic pain, and some PHN patients have obtained relief with temporary percutaneous spinal cord stimulation.…”

Section: Interventional Therapiesmentioning

confidence: 99%

Postherpetic Neuralgia: From Preclinical Models to the Clinic

et al. 2009

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Summary: Postherpetic neuralgia (PHN), a common complication of herpes zoster, which results from reactivation of varicella zoster virus, is a challenging neuropathic pain syndrome. The incidence and severity of herpes zoster and PHN increases with immune impairment or age and may become a greater burden both in terms of health economics and individual suffering. A clearer understanding of the underlying mechanisms of this disease and translation of preclinical outcomes to the clinic may lead to more efficacious treatment options. Here we give an overview of recent findings from preclinical models and clinical research on PHN.

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Effect of pulsed radiofrequency for postherpetic neuralgia

Abstract: PRF lesioning of DRG showed significant pain relief compared with the conventional treatments in patients with intractable PHN. In order to elucidate the mode of action of PRF, further research is needed and the optimal electrical parameters of PRF have to be determined.

Cited by 51 publications

References 9 publications

Interventional management of neuropathic pain: NeuPSIG recommendations

Interventional management of neuropathic pain: NeuPSIG recommendations

Neurosurgeons’ Armamentarium for the Management of Refractory Postherpetic Neuralgia: A Systematic Literature Review

Postherpetic Neuralgia: From Preclinical Models to the Clinic

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