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Jong il choe , Sang Dae Kim , Dong Jun Lim , Jung Yul Park |
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Department of Neurosurgery, Korea University College of Medicine, Ansan Hospital, Korea |
| 75세 이상의 고령환자에서 신경차단술 후
고주파신경절개술의 료 효과 |
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| Abstract |
Objective
s: The goal of this study was to validate the therapeutic role of radiofrequency neurotomy after nerve
block in elderly patients over 75 years of age.
Methods
A retrospective analysis was conducted based on the data obtained from 37 patients, 75 years or older,
during three-year-period with painful condition in whom radiofrequency neurotomy was performed after nerve blocks.
Causes of painful conditions were spinal stenosis, degenerative disc disease, compression fracture, facet syndrome
and trigeminal neuralgia. Initially, 156 patients were treated with nerve block (medial branch block, dorsal root block,
gray ramus communicans nerve block were included among various treatment option). Among 156 patients treated
with nerve blocks, 37 patients (23.7%) showed either recurrent painful episodes following successful pain reduction
from nerve blocks or remnants of substantial pain following various nerve blocks. In these 37 patients, radiofrequency
treatments (conventional medial branch gangliotomy, and pulsed RF DRG gangliotomy) were per- formed. After 4
weeks, the outcome of pain procedures was analyzed by using Visual analog scale(VAS) along with degrees of
patient satisfaction.
Results
All patients tolerated procedures well. Initial VAS score was 7.12. Thirty-seven of 156 patients (23.6%)
underwent RF treatments. An average of 2.8 nerve blocks were done. Post-block VAS score was 5.4 in 37 patients
and post-radiofrequency therapy VAS score 3.12. None of these patients required other surgical procedures during
follow-up period. Thirty-three (89.1%) patients were satisfied with the treatments provided. There were no procedurerelated
complications.
Conclusion
The radiofrequency therapy after nerve block procedures is considered as a safe and effective therapeutic
option for even elderly patients over 75 years of age who show unsatisfactory to conservative managements including
medication or physical therapy. |
| Key Words:
RadiofrequencyㆍNeurotomyㆍNerve blockㆍElderlyㆍBack pain |
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