FWD:[RSD-WorldNews] Percutaneous Radiofrequency Treatment for Refractory Pain Sy

By Mashawnda Dowell

WASHINGTON, DC -- May 4, 2007 -- Percutaneous conventional
radiofrequency (CRF) and pulsed radiofrequency (PRF) are minimally
invasive and safe procedures that provide substantial pain relief in
patients for a prolonged period when carefully selected and precisely
performed.

Radiofrequency treatment has been used for more than three decades for
intractable pain syndromes. Although neuromodulative treatment is
preferred for chronic pain syndromes, it still plays a role in the
management of various pain syndromes.

Jung Yul Park, MD, PhD, department of neurosurgery, Korea University
Medical Center, Assan Hospital, Seoul, Korea, presented the results of
the study here at the American Associated of Neurological Surgeons
(AANS) annual meeting.

The study evaluated the indications, efficacy, and complications
associated with CRF and PRF in a total of 3000 subjects with
intractable pain syndromes during a 10-year period.

Techniques evaluated were medial branch neurotomy, dorsal root
ganglionotomy, gasserian ganglion rhizotomy, trigeminal neurotomy,
sympathectomy, dorsal root entry zone lesioning, cordotomy,
thalamotomy, peripheral neutomy, stellate ganglion lesioning, and
sphenopalatine ganglion lesioning.

All procedures were performed under local anesthesia except dorsal
root entry zone and gasserian ganglion lesioning, which required
general anesthesia.

Successful results were defined as more than 50% pain relief for more
than 6 months. This was achieved in 45% to 92% of patients depending
on the pain condition.

Compared with CRF, PRF provided a less immediate effect, less maximal
pain reduction, and more frequent recurrence of pain. However, the PRF
procedure did not cause any discomfort now did it result in the need
for additional analgesia or anesthetics during or after the procedure.

No permanent complications were recorded from any of the procedures.
Most of the complications occurred after CRF. Repeated procedures were
performed in 28.1 % of patients due to recurrences with similar results.

The researchers concluded that conventional radiofrequency and pulsed
radiofrequency are minimally invasive and safe procedures that provide
substantial pain relief in a majority of patients for a prolonged
period when carefully selected and precisely performed.