scholarly journals Pulsed radiofrequency of C2 dorsal root ganglion under ultrasound guidance for chronic migraine: a case report

2018 ◽  
Vol Volume 11 ◽  
pp. 1915-1919 ◽  
Author(s):  
Jun Li ◽  
Yan Yin ◽  
Ling Ye ◽  
Yunxia Zuo
2017 ◽  
pp. 223-229
Author(s):  
Young-Chang Arai

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


2021 ◽  
Vol 14 (5) ◽  
pp. e241353
Author(s):  
Gaurav Chauhan ◽  
Brandon I Roth ◽  
Nagy Mekhail

Dorsal root ganglion stimulation (DRGS) therapy is a rapidly emerging tool being used by pain physicians in the treatment of chronic pain. Complex regional pain syndrome (CRPS), a debilitating disease whose mechanism is still has yet to be fully elucidated, is a common pathology targeted by DRGS therapy, often better results than traditional spinal cord stimulation. DRGS therapy, however, is not bereft of complications. Lead migration and fracture are two examples in particular that are among the most common of these complications. The authors report an unusual case of lost efficacy due to lead fractures in patients with CRPS treated with DRGS. The case report narrates identification, management and probable mechanism of DRGS lead fracture. The structural instability of DRGS leads can yield distressing symptoms at any point during the therapy, and physicians should be cognisant of the complications of DRGS therapy.


2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Xueru Xu ◽  
Shaoxiong Fu ◽  
Xiaomei Shi ◽  
Rongguo Liu

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.


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