Radiofrequency neurolysis in a clinical model

Smith, Hilary; McWhorter, Joe M.; Challa, Venkata R.

doi:10.3171/jns.1981.55.2.0246

Cited by 182 publications

(83 citation statements)

References 7 publications

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“…In our 40°C group this number was 51% (con trol, 40°C radiofrequency lesion, 3 months follow-up). Although temperature rise is known to have a selective ana tomical effect on small myelinated and unmyelinated nerve fibers (Smith et al, 1981), long-term effects on nerve action potentials have not been studied in these settings. In other fields of medicine electrical current is known to have longlasting effects on neuronal function, e.g., cardioversion where several rhythm disorders of the heart can be perma nently converted to a sinus rhythm.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of radiofrequency lesioning of the cervical spinal dorsal root ganglion in a double blinded randomized study: no difference between 40°C and 67°C treatments

Slappendel¹,

Crul²,

Braak³

et al. 1997

Pain

159

113

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The efficacy o f radiofrequency lesion treatment of the cervical dorsal root ganglion (RF-DRG) in cervicobrachialgia w as investigated in 61 patients by a random ized prospective double blinded study. Before lesion treatment the putative pain provoking spinal root was identified by diagnostic blocks with a local anesthetic agent. One group of patients (n = 32, group I) was treated with a radiofrequency lesion o f 67°C and in a control group (n = 29, group II) a temperature of 40°C was applied. Three months after treatment a significant reduction in V AS scores was dem onstrated in both groups. The outcome of the treatments was identical (VAS reduction: group I, 1.7; group II, 1.9; P = 0.001). In group I a VAS reduction of 3 or more occurred in 11/31 (34%) and in group II in 11/29 (38%) of patients. A V A S reduction of 2 or m ore occurred in group I in 15/31 (47%) and in group II in 15/29 (51%) of patients, This study suggests that treatm ent with 40°C radiofrequency application of the dorsal root ganglion is equally effective as treatment at 67°C. Further appraisal o f this treatment is required. © 1997 International Association for the Study of Pain. Published by Elsevier Science B.V.

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Section: Discussionmentioning

confidence: 99%

The efficacy of radiofrequency lesioning of the cervical spinal dorsal root ganglion in a double blinded randomized study: no difference between 40°C and 67°C treatments

Slappendel¹,

Crul²,

Braak³

et al. 1997

Pain

159

113

View full text Add to dashboard Cite

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“…The lesions destroyed the nerve fibers at the point of the ganglion, while the distant part of the branch remained intact and could conduct the potentials. In addition, the selective damage of pain-mediating small A-d and C fibers with preservation of A-b fibers at 80°C 9,20,21 may be another reason for this observation.…”

Section: Discussionmentioning

confidence: 99%

Use of sensory and motor action potentials to identify the position of trigeminal nerve divisions for radiofrequency thermocoagulation

Lin¹,

Lu²,

Zhai³

et al. 2014

JNS

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Object The objective of this study was to develop an electrophysiological method for intraoperative localization of the trigeminal nerve branches during radiofrequency thermocoagulation (RFTC). Methods Twenty-three patients who were scheduled to undergo RFTC were included. The trigeminal nerve root was stimulated through the foramen ovale using the radiofrequency cannula. Antidromic responses were recorded from the target division through supraorbital, infraorbital, and mental foramina electrodes, and an additional electrode at the masseter muscle. Sensory and motor action responses, as well as verbal and masseter contraction responses, were recorded and correlated. Results The antidromic responses were easily recorded in the target division in all 23 patients, and they were invariably correlated with the patient's verbal responses. The potentials were recorded successively from V1 to V3. The amplitude in each division before and after RFTC showed little difference in response to electrical stimulation with the same current. The motor trigeminal nerve action potentials were recorded in 10 patients; 7 of these patients had postoperative masseter muscle weakness, while the remaining 3 had normal masseter muscle function. Potentials with low amplitudes were usually obtained from neighboring divisions, but no unexpected denervation of any branches was observed. All the patients experienced immediate pain relief after the procedure. Conclusions This technique is sensitive and easy to apply. The sensory and motor potentials matched the verbal responses and the complications. Although it cannot completely substitute for the patient's verbal response, this approach is helpful in uncooperative patients, and it predicts and reduces the incidence of masseter muscle weakness. The use of these complementary techniques could increase the chances of treatment success.

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“…Thermal RF caused by continuous current within frequencies between 300 Hz and 300 GHz generates both current and heat on exposed tissues. Since temperatures above 45°C result in nonselective destruction of both myelinated and nonmyelinated nerve fibers (Smith et al, 1981), the thermal RF procedure has limited applications and caused some adverse effects. Unlike continuous RF, PRF generates intermittent pulsed current which lowers the target tissue temperature to below 45°C and causes different neurobiological effects (Cahana et al, 2003).…”

Section: Principles and Mechanisms Of Radiofrequencymentioning

confidence: 99%