A Patient-Mount Navigated Intervention System for Spinal Diseases and Its Clinical Trial on Percutaneous Pulsed Radiofrequency Stimulation of Dorsal Root Ganglion

Spine ◽  
2010 ◽  
Vol 35 (21) ◽  
pp. E1126-E1132 ◽  
Author(s):  
Chi-Lin Yang ◽  
Been-Der Yang ◽  
Mu-Lien Lin ◽  
Yao-Hung Wang ◽  
Jaw-Lin Wang
Keyword(s):  
Clinical Trial ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Spinal Diseases ◽  
Pulsed Radiofrequency ◽  
Stimulation Of

Pulsed radiofrequency adjacent to the cervical dorsal root ganglion in chronic cervical radicular pain: A double blind sham controlled randomized clinical trial

Pain ◽  
2007 ◽  
Vol 127 (1) ◽  
pp. 173-182 ◽  
Author(s):  
Jan Van Zundert ◽  
Jacob Patijn ◽  
Alfons Kessels ◽  
Inge Lamé ◽  
Hans van Suijlekom ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Dorsal Root Ganglion ◽  
Randomized Clinical Trial ◽  
Dorsal Root ◽  
Radicular Pain ◽  
Pulsed Radiofrequency ◽  
Double Blind

scholarly journals The Effect of Bipolar Pulsed Radiofrequency Treatment on Chronic Lumbosacral Radicular Pain Refractory to Monopolar Pulsed Radiofrequency Treatment

2018 ◽  
Vol 1 (21;1) ◽  
pp. E97-E103 ◽  
Author(s):  
Min Cheol Chang
Keyword(s):  
Pain Relief ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Radicular Pain ◽  
Pulsed Radiofrequency ◽  
Lumbosacral Radiculopathy ◽  
Radiofrequency Treatment ◽  
Pulsed Radiofrequency Treatment ◽  
Number Of Patients ◽  
Stimulation Of

Background: Patients with lumbosacral radicular pain may complain of persisting pain after monopolar pulsed radiofrequency (PRF) treatment. Objective: We evaluated the effect of bipolar PRF stimulation of the dorsal root ganglion (DRG) in patients with chronic lumbosacral radicular pain who were unresponsive to both monopolar PRF stimulation of the DRG and transforaminal epidural steroid injection (TFESI). Study Design: This is a prospective observational study. Setting: The outpatient clinic of a single academic medical center in Korea. Methods: We retrospectively reviewed data from 102 patients who had received monopolar PRF to the DRG for management of lumbosacral radiculopathy. Of these, 32 patients had persistent radicular pain that was scored at least 5 on a numeric rating scale (NRS). Twenty-three of them were included in this study and underwent bipolar PRF of the DRG. The outcomes after the procedure were evaluated using the NRS for radicular pain before treatment and 1, 2, and 3 months after treatment. Successful pain relief was defined as ≥ 50% reduction in the NRS score compared with the score prior to treatment. Furthermore, at 3 months after treatment, patient satisfaction levels were examined. Patients reporting very good (score = 7) or good results (score = 6) were considered to be satisfied with the procedure. Results: The NRS scores changed significantly over time. At 1, 2, and 3 months after bipolar PRF, the NRS scores were significantly reduced compared with the scores before the treatment. Twelve (52.2%) of the 23 patients reported successful pain relief and were satisfied with treatment results 3 months after bipolar PRF. No serious adverse effects were recorded. Limitations: A small number of patients were recruited and we did not perform long-term follow-up. Conclusion: We believe the use of bipolar PRF of the DRG can be an effective and safe interventional technique for chronic refractory lumbosacral radiculopathy. It appears to be a potential option that can be tried before proceeding to spinal surgery. Key words: Bipolar, pulsed radiofrequency, lumbosacral radicular pain, chronic pain, dorsal root ganglion, spinal stenosis, herniated disc

scholarly journals Pulsed Radiofrequency Application at Some Dorsal Root Ganglions Could Cause Drastic Neuromodulation throughout the Whole Body

2017 ◽  
pp. 223-229
Author(s):  
Young-Chang Arai
Keyword(s):  
Dorsal Root Ganglion ◽  
Analgesic Effect ◽  
Dorsal Root ◽  
Nervous Tissue ◽  
Case Series ◽  
Nerve Fibers ◽  
Whole Body ◽  
Intractable Pain ◽  
Pulsed Radiofrequency ◽  
Modified Technique

Background: The modified technique, pulsed radiofrequency (PRF) procedure, applied to nervous tissue has been providing anecdotal benefits for the management of chronic and intractable pain conditions. Although PRF has a neuromodulatory effect instead of thermally lesioning nervous tissue, the mechanism underlying the analgesic effect of PRF has not been fully clarified yet. Objectives: To see the changes of electricallyevoked responses of peripheral A-δ and A-β nerve fibers and the analgesic effect induced by PRF. Study Design: Case series. Setting: Inpatient. Methods: This study investigated how dorsal root ganglion (DRG) PRF influenced electricallyevoked responses of peripheral A-δ and A-β nerve fibers at the treated root ganglion dominating areas in five patients with intractable vertebral metastatic pain. Results: DRG PRF provided sound pain relief for patients with intractable vertebral metastatic pain. PRF application at DRGs had a different effect on electrically-evoked responses of peripheral A-δ and A-β nerve fibers at not only the treated root ganglion dominating areas but also the nontreated root ganglion dominating areas far from the treated root ganglion dominating areas in each patient. Limitation: This report is a case series. Conclusions: PRF application at some peripheral nerves could cause drastic neuromodulation throughout the whole body. Key words: Pulsed radiofrequency, dorsal root ganglion block, neuromodulation

scholarly journals Microglial BDNF, PI3K, and p-ERK in the Spinal Cord Are Suppressed by Pulsed Radiofrequency on Dorsal Root Ganglion to Ease SNI-Induced Neuropathic Pain in Rats

2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Xueru Xu ◽  
Shaoxiong Fu ◽  
Xiaomei Shi ◽  
Rongguo Liu
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Dorsal Root Ganglion ◽  
Nerve Injury ◽  
Calcium Binding ◽  
Dorsal Root ◽  
Intrathecal Injection ◽  
Pulsed Radiofrequency ◽  
Erk Phosphorylation ◽  
Extracellular Signal

Background. Pulsed radiofrequency (PRF) on the dorsal root ganglion (DRG) has been applied to alleviate neuropathic pain effectively, yet the mechanisms underlying pain reduction owing to this treatment are not clarified completely. The activated microglia, brain-derived neurotrophic factor (BDNF), phosphatidylinositol 3-kinase (PI3K), and phosphorylated extracellular signal-regulated kinase (p-ERK) in the spinal cord were demonstrated to be involved in developing neuropathic pain. Also, it has been just known that PRF on DRG inhibits the microglial activation in nerve injury rats. Here, we aim to investigate whether PRF treatment could regulate the levels of BDNF, PI3K, and p-ERK in the spinal cord of rats with spared nerve injury (SNI) via suppressing the spinal microglia activation to ease neuropathic pain. Methods. The rats with SNI were intrathecally treated with minocycline (specific microglia inhibitor) or same volume of dimethyl sulfoxide once daily, beginning from 1 h before nerve transection to 7 days. PRF was applied adjacent to the L4-L5 DRG of rats with SNI at 45 V for 6 min on the seventh postoperative day, whereas the free-PRF rats were treated without PRF. The withdrawal thresholds were studied, and the spinal levels of ionized calcium-binding adapter molecule 1 (Iba1), BDNF, PI3K, and p-ERK were calculated by western blot analysis, reverse transcription-polymerase chain reaction, and immunofluorescence. Results. The paw withdrawal mechanical threshold and paw withdrawal thermal latency decreased in the ipsilateral hind paws after SNI, and the spinal levels of Iba1, BDNF, PI3K, and p-ERK increased on day 21 after SNI compared with baseline (P<0.01). An intrathecal injection of minocycline led to the reversal of SNI-induced allodynia and increase in levels of Iba1, BDNF, PI3K, and p-ERK. Withdrawal thresholds recovered partially after a single PRF treatment for 14 days, and SNI-induced microglia hyperactivity, BDNF upregulation, and PI3K and ERK phosphorylation in the spinal cord reduced on D14 due to the PRF procedure. Conclusion. Microglial BDNF, PI3K, and p-ERK in the spinal cord are suppressed by the therapy of PRF on DRG to ease SNI-induced neuropathic pain in rats.

Randomized controlled trials between dorsal root ganglion thermal radiofrequency, pulsed radiofrequency and steroids for the management of intractable metastatic back pain in thoracic vertebral body

2020 ◽  
pp. 204946372094253
Author(s):  
Sherry Nabil Fanous ◽  
Emad Gerges Saleh ◽  
Ekramy Mansour Abd Elghafar ◽  
Hossam Zarif Ghobrial
Keyword(s):  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Oral Morphine ◽  
Good Alternative ◽  
Drop Out ◽  
Pulsed Radiofrequency ◽  
Vertebral Metastasis ◽  
Randomized Controlled ◽  
Augmentation Techniques ◽  
Axial Pain

Background: Bone metastasis is a complication of various cancers causing severe pain. The current modalities for the treatment of metastatic axial pain include pharmacological, surgical and vertebral augmentation techniques, each of which has its own challenges. Objectives: To evaluate the effectiveness of pulsed radiofrequency (PRF), thermal radiofrequency (RF) and steroids on dorsal root ganglion (DRG) in patients with thoracic axial pain due to vertebral metastasis. Methods: In this randomized controlled prospective study, 140 patients were assessed for eligibility, of which only 69 fulfilled the criteria. Patients were randomly divided into three equal groups, PRF, RF and steroid. Results: During the assessment of pain using Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Opioid consumption using oral Morphine Equivalence (OME) and Analgesic Quantification Algorithm (AQA) – at baseline, 1 week, 1 month and 3 months – 81 patients were assessed for final eligibility, of which 12 were excluded before intervention due to drop-out. The remaining 69 were randomized (mean age: 53.87 ± 10.55, 55.78 ± 7.34 and 59.39 ± 13.72) for PRF, RF and steroid, respectively with no statistical difference. VAS% and ODI% decreased significantly at 3 months in RF group ( p <0.001, 0.014, respectively), as did the AQA ( p <0.027). Steroid group was the worst. Discussion: RF on DRG is the main stay for controlling intractable metastatic pain. PRF is a good alternative.

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