Morphologic Analysis of Bipolar Radiofrequency Lesions: Implications for Treatment of the Sacroiliac Joint

Pino, Carlos A.; Hoeft, Mark A.; Hofsess, Craig; Rathmell, James P.

doi:10.1016/j.rapm.2005.03.014

Cited by 43 publications

(58 citation statements)

References 11 publications

(9 reference statements)

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“…[19] Similarly, Pino et al noted that bipolar RF created the largest lesion in performing thermocoagulation at 90 o C for 120-150 seconds with 4-6 mm intervals of two electrodes. [21] Derby and Lee reported that bipolar electrodes produce greater thermocoagulation and better coagulation on a larger area than that of monopolar electrodes. [22] In our study, radiofrequency lesioning was created at a temperature of 80°C for 120 seconds in both groups.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency termocoagulation for the treatment of lower extremity ischemic pain: Comparison of monopolar and bipolar modes

Destegül¹,

Işik²,

Özbek³

et al. 2017

Agri

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SummaryObjectives: Radiofrequency thermocoagulation (RFT) has been reported to be used safely to treat ischemic lower extremity pain. The objective of the present study was to evaluate efficiency of RFT for treatment of lower extremity ischemic pain and to compare effectiveness of monopolar RFT and bipolar RFT modes. Methods: Following ethics committee approval, 30 American Society of Anesthesiologists classification I-III patients with ischemic lower extremity pain aged between 18 and 65 years were recruited. Patients were randomly allocated into 2 groups: MRT group (n=15) received monopolar RFT (80°C) for 2 minutes at L2-3 level, and BRT group (n=15) received bipolar RFT (80°C) for 2 minutes at L2-3 level. Systolic and diastolic blood pressure, heart rate, pain score, and supplemental analgesic requirements were recorded at 24 hours after application and at 7, 30, and 90 days. Results: Numerical rating scale values in both groups decreased significantly over time and it was found to be significantly lower in BRT group after first and third months (p<0.05). Supplemental analgesic requirements were similar with no significant difference between the 2 groups at any point of study period (p>0.05). No adverse event or complication related to procedure or treatment was reported. Conclusion: In patients with ischemic lower extremity pain, both monopolar and bipolar RFT treatment modalities were found to significantly decrease pain levels. However, bipolar mode led to lower pain scores at 30 and 90 days, and longer duration of analgesia than monopolar mode.Keywords: Radiofrequency thermocoagulation; monopolar; bipolar; ischemic pain; lumbar sympatholysis. ÖzetAmaç: Alt ekstremitenin iskemik ağrı tedavisi için radyofrekans termokoagülasyon'un (RFT) güvenle kullanılabileceği bildirilmiştir. Bu çalışmanın amacı alt ekstremitenin iskemik ağrı tedavisi için RFT'un etkinliğini değerlendirmek ve monopolar ve bipolar RFT modlarını karşılaştırmaktı. Gereç ve Yöntem: Etik komite kabulünü takiben alt ekstremite iskemik ağrısı olan, yaşları 18-65 yaş arası, ASA I-III grubu, 30 hasta çalışmaya alındı. Hastalar MRT grubunda (n=15) L 2-3 düzeyinden 2 dakika monopolar RFT (80°C), BRT grubunda (n=15) ise L 2-3 düzeyinden 2 dakika bipolar RFT (80°C) almak üzere rastgele iki gruba ayrıldı. Sistolik ve diastolik kan basınçları, kalp atım hızı, ağrı skorları (NRS) ve ek analjezik ihtiyaçları hastaneden taburcu edildikten 24 saat ve 7, 30 ve 90. günlerde kaydedildi. Bulgular: Her iki grupta NRS skorlarının zaman içerisinde önemli derecede azaldığı ve BRT grubunda MRT grubuna göre 30 ve 90. günlerde istatistiksel olarak önemli derecede daha düşük olduğu tespit edildi (p<0.05). Bununla birlikte, ek analjezik ihtiyacının iki grupta benzer olduğu ve iki grup arasında çalışma periyodlarında istatistiksel fark oluşturmadığı tespit edildi (p>0.05). İşlem veya tedaviye ilişkin yan etki veya komplikasyon bildirilmedi. Sonuç: Alt ekstremitenin iskemik ağrı tedavisinde hem monopolar hem de bipolar radyofrekans termokoagülasyon tedavi modalitelerinin ...

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Section: Discussionmentioning

confidence: 99%

Radiofrequency termocoagulation for the treatment of lower extremity ischemic pain: Comparison of monopolar and bipolar modes

Destegül¹,

Işik²,

Özbek³

et al. 2017

Agri

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“…Several investigators have studied the morphology of bipolar lesions using various mediums, from animal tissue to egg white. Pino et al examined bipolar RF lesion patterns in egg white by heating 22-gauge electrodes in parallel [109]. They reported that the optimum contiguous 'strip' lesion occurred when the electrodes were placed 6 mm apart.…”

Section: Bipolar Rfmentioning

confidence: 99%

Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment

Cohen

Chen

Neufeld

2013

Expert Review of Neurotherapeutics

324

236

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Sacroiliac joint (SIJ) pain is an underappreciated source of mechanical low back pain, affecting between 15 and 30% of individuals with chronic, nonradicular pain. Predisposing factors for SIJ pain include true and apparent leg length discrepancy, older age, inflammatory arthritis, previous spine surgery, pregnancy and trauma. Compared with facet-mediated and discogenic low back pain, individuals with SIJ pain are more likely to report a specific inciting event, and experience unilateral pain below L5. Owing in part to its size and heterogeneity, the pain referral patterns of the SIJ are extremely variable. Although no single physical examination or historical feature can reliably identify a painful SIJ, studies suggest that a battery of three or more provocation tests can predict response to diagnostic blocks. Evidence supports both intra- and extra-articular causes for SIJ pain, with clinical studies demonstrating intermediate-term benefit for both intra- and extra-articular steroid injections. In those who fail to experience sustained relief from SIJ injections, radiofrequency denervation may provide significant relief lasting up to 1 year. This review covers all aspects of SIJ pain, with the treatment section being primarily focused on procedural interventions.

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“…5 Compared with conventional monopolar-RF, bipolar-RF has been shown to increase lesion size as a function of parameters such as lesioning time, temperature, fluid injection, and electrode active tip site and spacing. [5][6][7][8] Alternatively, cooled-RF was also developed to increase lesion size. It involves an electrode in which the tip is water-cooled for the duration of the lesion.…”

mentioning

confidence: 99%

An Ex Vivo Comparison of Cooled-Radiofrequency and Bipolar-Radiofrequency Lesion Size and the Effect of Injected Fluids

Vallejo

Benyamin

Tilley

et al. 2014

Regional Anesthesia and Pain Medicine

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Morphologic Analysis of Bipolar Radiofrequency Lesions: Implications for Treatment of the Sacroiliac Joint

Cited by 43 publications

References 11 publications

Radiofrequency termocoagulation for the treatment of lower extremity ischemic pain: Comparison of monopolar and bipolar modes

Radiofrequency termocoagulation for the treatment of lower extremity ischemic pain: Comparison of monopolar and bipolar modes

Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment

An Ex Vivo Comparison of Cooled-Radiofrequency and Bipolar-Radiofrequency Lesion Size and the Effect of Injected Fluids

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