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

Clinical Article

Journal of Korean Society of Geriatric Neurosurgery 2007;3(2):150-159.
Published online December 31, 2007.

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

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