Retrospective Study of the Analgesic Effect of Sacroiliac Joint Radiofrequency Denervation

BACKGROUND: Interventional radiofrequency (RF) ablation techniques are indicated when an adequate effect is not obtained with conservative measures. OBJECTIVES: The primary objective of this study was to evaluate pain relief after RF denervation of the sacroiliac joint. The secondary objective was to evaluate pain intensity and relief duration. STUDY DESIGN: The study was retrospective. SETTING: The study was conducted at Vera Cruz Hospital, Campinas, Brazil. METHODS: Data were collected from the medical records of patients undergoing RF denervation for low back pain originating in the sacroiliac joint, from January 2015 to December 2017. There were 78 patients studied, between 18 and 65 years old, of both genders, ASA I or II, who underwent knee arthroscopic meniscectomy. The patients were submitted to denervation of sacroiliac joint by 3 types of RF (conventional, pulsed, and cooled). The following parameters were evaluated, number of patients who obtained ? 50% pain relief; pain intensity, measured using the visual analog scale (before the procedure and 15, 30, 90 and 180 days after, performed by the same evaluator); and the use of complementary analgesic for 2 weeks. RESULTS: Of the 78 included patients, 56 (71.8%) underwent conventional RF, 9 (11.5%) underwent pulsed RF, and 13 (16.7%) underwent cooled RF. There were losses to follow-up including 40 patients who underwent conventional RF, 5 who underwent pulsed RF, and 12 who underwent cooled RF, who were retained for 6 months. There was significant pain relief with the three types of RF for up to 6 months of follow-up, with no difference among the types. After 6 months, 90.2% of patients who underwent conventional RF, 100% who underwent pulsed RF, and 91.7% who underwent cooled RF maintained ? 50% pain relief. Complementary analgesics were used by 95% of the patients who underwent conventional RF, 80% who underwent pulsed RF, and 91% who underwent cooled RF 2 weeks after the procedure. There were mild adverse effects, such as edema, hematoma, and local pain, without complications. LIMITATIONS: As for limitations, the number of pulsed and cooled RF is low and in a retrospective study some data may be missing, especially from follow-up. CONCLUSIONS: RF denervation of the sacroiliac joint is effective and promotes a long-lasting analgesic effect. KEY WORDS: Analgesia, denervation, low back pain, radiofrequency, sacroiliac joint

Combined Pulsed RF GD-OES and HAXPES for Quantified Depth Profiling through Coatings

Chemical characterization at buried interfaces is a real challenge, as the physico-chemical processes operating at the interface govern the properties of many systems and devices. We have developed a methodology based on the combined use of pulsed RF GD-OES (pulsed Radio Frequency Glow Discharge Optical Emission Spectrometry) and XPS (X-ray Photoelectron Spectroscopy) to facilitate the access to deeply buried locations (taking advantage of the high profiling rate of the GD-OES) and perform an accurate chemical diagnosis using XPS directly inside the GD crater. The reliability of the chemical information is, however, influenced by a perturbed layer present at the surface of the crater, hindering traditional XPS examination due to a relatively short sampling depth. Sampling below the perturbed layer may, however, can be achieved using a higher energy excitation source with an increased sampling depth, and is enabled here by a new laboratory-based HAXPES (Hard X-ray PhotoElectron Spectroscopy) (Ga-Kα, 9.25 keV). This new approach combining HAXPES with pulsed RF GD-OES requires benchmarking and is here demonstrated and evaluated on InP. The perturbed depth is estimated and the consistency of the chemical information measured is demonstrated, offering a new route for advanced chemical depth profiling through coatings and heterostructures.

Transdermal Delivery of Active Principles with Pulsed RF Contact Diathermy - A Narrative Review

The transdermal delivery of drugs and, in more general terms, of active principles can be performed by iontophoresis and/or by electroporation. The advantages of a local treatment vs. other drugs intake methods are well known as it reduces the systemic involvement and therefore the systemic contraindications. To perform the treatment exploiting the electroporation effect there is nowadays a specific variant of a known medical device used in physiotherapy: the Medium Frequency Resistive/Capacitive contact Diathermy. The adoption of a power control exploiting Pulse Width Modulation of the applied current adds to the device also this capability of great potential in rehabilitation and aesthetic medicine treatments. The theoretic approach is discussed and applications suggestions are being given.