Radiofrequency Techniques

Kline, Matthew T.

doi:10.1016/b978-0-7216-0334-6.50173-4

Cited by 17 publications

(23 citation statements)

References 77 publications

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“…In light of concerns of side effects associated with uncontrolled spread of neurolytic agents such as neurolytic injection with phenol, the CRFA can be more precise and controlled 28 . The rationale for the application of CRFA is the assumption that thermal coagulation denatures neuron‐structures and thereby stops nociceptive conduction 10 . Although CRFA has been used effectively for spinal pain, 10 others have questioned the utility of thermal lesioning in the presence of neuropathic pain 11,12 because of the possible neuroma formation as a result of wallerian degeneration and subsequent nerve regeneration 14 .…”

Section: Discussionmentioning

confidence: 99%

“…The rationale for the application of CRFA is the assumption that thermal coagulation denatures neuron‐structures and thereby stops nociceptive conduction 10 . Although CRFA has been used effectively for spinal pain, 10 others have questioned the utility of thermal lesioning in the presence of neuropathic pain 11,12 because of the possible neuroma formation as a result of wallerian degeneration and subsequent nerve regeneration 14 . In contrast, PRFA utilizes brief “pulses” of high‐voltage electric current producing an increase in temperature to 42°C.…”

Section: Discussionmentioning

confidence: 99%

“…Conventional radiofrequency ablation (CRFA) has been used effectively for spinal pain 10 . The rationale for the application of CRFA is the assumption that thermal coagulation denatures neuron‐structures and thereby stops nociceptive conduction 10 However, in the presence of neuropathic pain, 11,12 thermal lesioning carries the potential risk of neuritis and neuroma formation as a result of nerve damage (wallerian degeneration) and subsequent nerve regeneration 13,14 . Pulsed radiofrequency ablation (PRFA) has been recently described as an alternative technique that applies a relatively high voltage near a nerve without nerve injury 15 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pulsed Radiofrequency Ablation for Residual and Phantom Limb Pain: A Case Series

West

2010

Pain Practice

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Residual limb pain (RLP) and phantom limb pain (PLP) can be debilitating and can prevent functional gains following amputation. High correlations have been reported between RLP and the stump neuromas following amputation. Many treatment methods including physical therapy, medications, and interventions, have been used with limited success. Pulsed radiofrequency ablation (PRFA) has shown promise in treating neuropathic pain because of the inhibition of evoked synaptic activity. We present 4 amputees who were treated with PRFA after failing conservative management for their RLP and PLP. All 4 patients underwent PRFA and demonstrated at least 80% relief of RLP for over 6 months. One patient reported a complete resolution of phantom sensation while another patient had significantly decreased frequency of spontaneous PLP and resolution of evoked PLP. In addition, all patients reported improved overall function including increased prosthetic tolerance and decreased oral pain medications. This case series suggests that PRFA is a viable treatment option which might be used for long-term relief of intractable RLP and/or PLP.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pulsed Radiofrequency Ablation for Residual and Phantom Limb Pain: A Case Series

West

2010

Pain Practice

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“…136 For this purpose, at the lumbar levels a 10-cm electrode (22 gauge, 5-mm active tip) is placed in the dorsal cranial quadrant of the intervertebral foramen (lateral view) and introduced with its tip between a third and about halfway across the midfacetal column on the AP projection ( Fig. 136 For this purpose, at the lumbar levels a 10-cm electrode (22 gauge, 5-mm active tip) is placed in the dorsal cranial quadrant of the intervertebral foramen (lateral view) and introduced with its tip between a third and about halfway across the midfacetal column on the AP projection ( Fig.…”

Section: Procedures For Radiofrequency Treatment Of the Dorsal Root Gamentioning

confidence: 99%

Radiofrequency Treatment

Eerd¹,

Kleef²,

Zundert³

2014

Practical Management of Pain

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“…El tiempo de duración de paso de la corriente así como la geometría del electrodo también son parámetros fundamentales. Para conseguir una lesión permanente la corriente debe estar pasando durante 30 a 60 segundos como mínimo 11 . La cercanía a vasos sanguíneos, líquido cefalorraquídeo o hueso, puede alterar la cantidad de calor generado en la punta del electrodo.…”

Section: Técnicas De Radiofrecuenciaunclassified

Síndrome postlaminectomía lumbar I: Tratamiento del dolor mediante técnicas intervencionistas

Padrón

2007

Neurocirugía

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ResumenLa lumbalgia y la ciática postquirúrgicas representan unos síntomas por los que un elevado número de pacientes son remitidos a las Unidades del Dolor (UDO) en busca de soluciones a sus problemas. La futuras posibilidades de expansión de las Unidades Multidisciplinarias del Dolor (UMD) hacen que los neurocirujanos volvamos a recuperar el protagonismo perdido en los últimos años, por lo que es preciso exponer cuales son las técni-cas que desde nuestra especialidad podemos aportar a las nuevas UMD. No se entra en los aspectos quirúrgi-cos del síndrome postlaminectomía lumbar, que ocasionalmente los tiene, sino en la descripción de las técnicas percutáneas intervencionistas. La utilización escalonada de los bloqueos vertebrales con control radiológico junto a las técnicas de radiofrecuencia, permiten abrir un gran abanico de posibilidades para el control de este tipo de dolor. Las técnicas de neuromodulación aplicables al manejo del dolor crónico, serán tratadas en otro artículo. Las técnicas neuroablativas a nivel medular y/o cerebral ya no tienen aplicación en esta patología. No obstante, la simpatectomía lumbar y la termoneurolisis, vuelven a cobrar importancia en el manejo del dolor crónico lumbociático postquirúrgico. Se describen los distintos algoritmos de manejo del dolor según la estructura afectada. El empleo de la radiofrecuencia pulsada permite abordar con seguridad el ganglio de la raíz dorsal e incluso el propio nervio raquídeo, disminuyendo las eventuales complicaciones de las antiguas técnicas de radiofrecuencia. Se describen en detalle los aspectos fundamentales para la realización de las diferentes técnicas intervencionistas, aportando imágenes reales, lo que permitirá asimilar más fácilmente el conocimiento que quiere transmitirse.PALABRAS CLAVE: Síndrome postlaminectomía lumbar. Alivio del dolor. Técnicas intervencionistas. Bloqueos espinales. Radiofrecuencia. Lumbar post-laminectomy syndrome I. Pain management using interventionist techniques SummaryChronic low back pain and ciatica after surgery is one of the main reasons for referring patients to multidisciplinary pain units (MPU). The future expansions of MPU have promted neurosurgeons in Spain to re-enter the field of chronic pain management and to recover their enthusiam, that have been lost severel years ago for various reasons. We do not intend dealing with the new instrumented surgical options for the post-laminectoy pain, but rather into the indications and descriptions of the interventional techniques for lumbar and sciatic pain managemet. Currently there are a great number of percutaneous techniques to achieve pain control in the post-laminectomy syndrome. Traditional neuroablative techniques at the spinal cord or the cerebral levels are not any longer indicated. Nonetheless, lumbar sympathectomy and thermo-neurolisis either with chilling or heating, are back in favour, due to the development of new devices and applications. Neuromodulation techniques which are also applicable to this pathology will be the subjet of another art...

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Radiofrequency Techniques

Cited by 17 publications

References 77 publications

Pulsed Radiofrequency Ablation for Residual and Phantom Limb Pain: A Case Series

Pulsed Radiofrequency Ablation for Residual and Phantom Limb Pain: A Case Series

Radiofrequency Treatment

Síndrome postlaminectomía lumbar I: Tratamiento del dolor mediante técnicas intervencionistas

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