Targeted Radiofrequency Techniques

Calodney, Aaron; Rosenthal, Richard M.; Gordon, Abigail A.; Wright, Robert E.

doi:10.1007/978-3-319-27607-6_3

Cited by 7 publications

(11 citation statements)

References 118 publications

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“…However, RFA stands out to be the most effective and widely applied modality for alleviating chronic pain, as compared to its counterparts. Importantly, RFA is not a curative procedure and does not treat the root cause of pain, but it anesthetizes the source of patient's pain that usually lasts for about 12 months [7].…”

Section: Introductionmentioning

confidence: 99%

“…The interaction of high-frequency alternating current with the biological tissue initiates the rapid oscillations of charged molecules (mainly proteins) that generates heat. The rate of this ionic heating will be higher around the uninsulated active tip of the electrode, where the current density is largest [7][8]. The lethal temperature during the application of RFA for treating target nerve in mitigating chronic pain is considered to be at or above 45-50 o C. Moreover, it is highly undesirable, if the temperature within the biological tissue goes beyond 100 o C during the RFA procedure, as it would result in tissue boiling, vaporization and charring.…”

Section: Introductionmentioning

confidence: 99%

“…Also, the pulsed RFA can produce far stronger electrical fields as compared to the continuous RFA. Initially, the pulsed RFA was thought to be a completely non-destructive procedure for mitigating chronic pain, but recent research in the field suggests that there are both thermal and nonthermal effects of the pulsed RFA procedure [7]. What currently known is that, during the pulsed RFA, clinical effects are not only caused by the high-frequency alternating electrical current leading to heat-generated lesion, but also by the intense electric fields causing a change in the cellular behavior [11].…”

Section: Introductionmentioning

confidence: 99%

“…What currently known is that, during the pulsed RFA, clinical effects are not only caused by the high-frequency alternating electrical current leading to heat-generated lesion, but also by the intense electric fields causing a change in the cellular behavior [11]. Importantly, the pulsed RFA procedure is less destructive as compared to the conventional continuous RFA, as there have been no reports of neurological side effects [7].…”

Section: Introductionmentioning

confidence: 99%

“…Several feasibility studies have been reported utilizing the application of the pulsed RFA in treating some of chronic pain conditions [12][13][14][15][16][17][18]. Although several available clinical studies on pulsed RFA techniques portray their effectiveness, especially among patients who suffer from radicular pain and peripheral neuropathies, the exact explanation of the mechanisms of action during the pulsed RFA still remains elusive [7]. Thus, further research is needed to determine the clinical effectiveness of pulsed RFA among different chronic conditions for long term pain relief.…”

Section: Introductionmentioning

confidence: 99%

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Computational Science – ICCS 2019

2019

Lecture Notes in Computer Science

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In this paper, a parametric study has been conducted to evaluate the effects of frequency and duration of the short burst pulses during pulsed radiofrequency ablation (RFA) in treating chronic pain. Affecting the brain and nervous system, this disease remains one of the major challenges in neuroscience and clinical practice. A two-dimensional axisymmetric RFA model has been developed in which a single needle radiofrequency electrode has been inserted. A finite-element-based coupled thermo-electric analysis has been carried out utilizing the simplified Maxwell's equations and the Pennes bioheat transfer equation to compute the electric field and temperature distributions within the computational domain. Comparative studies have been carried out between the continuous and pulsed RFA to highlight the significance of pulsed RFA in chronic pain treatment. The frequencies and durations of short burst RF pulses have been varied from 1 Hz to 10 Hz and from 10 ms to 50 ms, respectively. Such values are most commonly applied in clinical practices for mitigation of chronic pain. By reporting such critical input characteristics as temperature distributions for different frequencies and durations of the RF pulses, this computational study aims at providing the first-hand accurate quantitative information to the clinicians on possible consequences in those cases where these characteristics are varied during the pulsed RFA procedure. The results demonstrate that the efficacy of pulsed RFA is significantly dependent on the duration and frequency of the RF pulses.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Computational Science – ICCS 2019

2019

Lecture Notes in Computer Science

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Bioinformatics and Biomedical Engineering

2019

Lecture Notes in Computer Science

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The present study aims at evaluating the effects of target nerve location from the bone tissue during continuous radiofrequency ablation (RFA) for chronic pain relief. A generalized three-dimensional heterogeneous computational model comprising of muscle, bone and target nerve has been considered. The continuous RFA has been performed through the monopolar needle electrode placed parallel to the target nerve. Finite-element-based coupled thermoelectric analysis has been conducted to predict the electric field and temperature distributions as well as the lesion volume attained during continuous RFA application. The quasi-static approximation of the Maxwell's equations has been used to compute the electric field distribution and the Pennes bioheat equation has been used to model the heat transfer phenomenon during RFA of the target nerve. The electrical and thermo-physical properties considered in the present numerical study have been acquired from the well-characterized values available in the literature. The protocol of the RFA procedure has been adopted from the United States Food and Drug Administration (FDA) approved commercial devices available in the market and reported in the previous clinical studies. Temperature-dependent electrical conductivity along with the piecewise model of blood perfusion have been considered to correlate with the in-vivo scenarios. The numerical simulation results, presented in this work, reveal a strong dependence of lesion volume on the target nerve location from the considered bone. It is expected that the findings of this study would assist in providing a priori critical information to the clinical practitioners for enhancing the success rate of continuous RFA technique in addressing the chronic pain problems of bones.

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