Nerve Block and Radiofrequency Treatment
for Chronic Refractory Spinal Pain in Aged Patients |
Je-On Park , Dong-Hyuk Park , Sang-Dae Kim, Se-Hoon Kim , Dong-Jun Lim , Jung-Yul Park |
Department of Neurosurgery, Korea University College of Medicine, Ansan Hospital, Korea |
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Abstract |
Objective Prospectively, a total of 106 consecutive patients with chronic neck or back pain were selected for nerve
blocks with or without radiofrequency treatments between October, 2006 and March, 2007 in our department.
Materials and Methods: When symptoms and signs recurred after initial substantial pain relief (≥50% pain
reduction) with nerve blocks, the radiofrequency (RF) treatments were followed during this period. Radiofrequency
neurotomy involved using conventional, heat-produced thermocoagulation on posterior primary ramus for back pain
and pulsed radiofrequency lesioning on dorsal root ganglion for radicular pain to lower extremities.
Results Of these 106 patients, 38 underwent RF treatments of the posterior primary ramus (PPR) or/and dorsal
root ganglion (DRG) for more definitive, a long-term control of recurrent or persistent pain. For the therapeutic effect
of nerve blocks with local anesthetics and steroid, 28 of 51 (55%) patients showed good to excellent pain relief
at 6 months of follow-up. With respect to effect of RF treatments, 16 of 25 (64%) patients still showed good to excellent
pain relief at six months of follow-up period. There were no significant complications associated with these procedures.
Conclusions These results indicate that nerve blocks and RF treatments provide substantial pain relief with many
advantages, such as good efficacy, simplicity and safety of the procedure, repeatability, minimal stay in hospital, long
duration of pain relief and the feasibility of procedure. Thus, these minimal invasive procedures can be recommended
in aged patients with chronic neck or back pain that are not controlled with conservative managements or not suitable
for surgery. |
Key Words:
AgedㆍNerve blockㆍRadiofrequency lesionㆍPainㆍIntractable |
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