BACKGROUND: Pulsed radiofrequency (PRF) is a treatment modality that alleviates radicular pain by intermittently applying high-frequency currents adjacent to the dorsal root ganglion. There has been no comparative study on analgesic effect according to the position of the needle tip in PRF treatment. The objective of this study is to evaluate the clinical outcomes of PRF according to the needle tip position. METHODS: Patients were classified into 2 groups (group IP [group inside of pedicle] and group OP [group outside of pedicle]) based on needle tip position in the anteroposterior view of fluoroscopy. In the anteroposterior view, the needle tip was advanced medially further than the lateral aspect of the corresponding pedicle in group IP; however, in group OP, the needle tip was not advanced. The treatment outcomes and pain scores were evaluated at 4, 8, and 12 weeks after applying PRF. RESULTS: At 4, 8, and 12 weeks, there were no significant differences between the successful response rate and numerical rating scale score ratio. CONCLUSIONS: The analgesic efficacy of PRF treatment did not differ with the needle tip position.
Analgesics ; Fluoroscopy ; Ganglia, Spinal ; Humans ; Low Back Pain ; Lumbosacral Region ; Needles ; Observational Study ; Pulsed Radiofrequency Treatment ; Radiculopathy ; Retrospective Studies ; Spinal Nerve Roots

BACKGROUND AND OBJECTIVES: The effectiveness of turbinate surgery has been well demonstrated in allergic rhinitis refractory to medication. On the contrary, the efficacy of surgery in allergic rhinitis that responds to medication has not been assessed. The aim of this study was to determine the surgical outcomes in patients with allergic rhinitis responsive to medication. SUBJECTS AND METHOD: Patients with allergic rhinitis responsive to medication and those who had undergone coblation turbinate reduction were enrolled in this study. The visual analog scale was used to assess the allergic symptoms before treatment, during medication treatment as well as postoperatively at 6 and 12 months. In addition, the degree of patient satisfaction regarding the surgery was investigated postoperatively at 12 months. RESULTS: Twenty-four patients (mean age=33.6±14.9 years; men-to-women ratio=1:1) were included in this study. During the pretreatment period, all allergic symptoms significantly improved after treatment with both medication and surgery. At 6 months postoperatively, the degree of patients' allergic symptoms was lower than in those treated with medication. However, when compared at 12 months postoperatively, all the symptoms, excluding nasal obstruction, were not significantly different from those who received medication. Surveyed postoperatively at 12 months 54.2% of patients advocated for surgical treatment. CONCLUSION: Although surgery yielded better outcome than did medication during the early postoperative period, there was little difference in the outcome at 12 months postoperatively. Therefore, we need to be careful when choosing surgical intervention for patients with allergic rhinitis responsive to medication.
Humans ; Methods ; Nasal Obstruction ; Patient Satisfaction ; Postoperative Period ; Pulsed Radiofrequency Treatment ; Rhinitis, Allergic* ; Treatment Outcome ; Turbinates* ; Visual Analog Scale

OBJECTIVE: To investigate the effect of pulsed radiofrequency (PRF) treatment on pain and balance in patients with lumbosacral radiculopathy.METHOD: This study included twenty-five patients who were diagnosed with chronic lumbosacral radiculopathy. They underwent PRF treatment in prone position under the fluoroscopic guidance. The effect of PRF was measured by the visual analog score (VAS). Patient ability to balance was evaluated by using the Tetra-ataxiometric posturography (Tetrax).RESULTS: After PRF all patients showed improvement in pain as measured by VAS (p < 0.001) and none of the patients reported any side effects. The posturographic balance, which was evaluated by Tetrax showed no significant decline after PRF treatment. The weight distribution index (WDI) with eyes open before treatment was 5.43 ± 2.88 and after treatment was 5.37 ± 2.65 (p=0.917). The mean stability index (SI) with eyes open before treatment was 16.52 ± 6.05 and after treatment was 16.61 ± 4.85 (p=0.906). The mean WDI with eyes closed before treatment was 5.66 ± 2.81 and after treatment was 5.16 ± 2.70 (p=0.470). Finally, the mean SI with eyes closed before was 25.88 ± 9.88 and after treatment was 25.99 ± 12.30 (p=0.962).CONCLUSION: The results suggest that PRF has an effect on pain in patients with chronic lumbosacral radiculopathy. The patients did not experience adverse effects, such as hypoesthesia, dysesthesia and decreased proprioception after PRF, and there were no significant declines in balance.
Humans ; Hypesthesia ; Methods ; Paresthesia ; Postural Balance ; Prone Position ; Proprioception ; Pulsed Radiofrequency Treatment ; Radiculopathy

Meralgia paresthetica (MP) is a sensory mononeuropathy, caused by compression of the lateral femoral cutaneous nerve (LFCN) of thigh. Patients refractory to conservative management are treated with various interventional procedures. We report the first use of extended duration (8 minutes) pulsed radiofrequency of the LFCN in a case series of five patients with refractory MP. Four patients had follow up for 1–2 years, and one had 6 months follow up. All patients reported remarkable and long lasting symptom relief and an increase in daily life activities. Three patients came off medications and two patients required minimal doses of neuropathic medications. No complications were observed.
Analgesia ; Catheter Ablation ; Chronic Pain ; Follow-Up Studies ; Humans ; Mononeuropathies ; Neuralgia ; Pain Management ; Pulsed Radiofrequency Treatment ; Thigh

While most benign hiccups can be controlled with empirical therapy, intractable hiccups lasting longer than one month tend to have significant adverse effects with obscure etiology. Treatment strategies for intractable hiccups have not been established. Only a few sporadic cases of bilateral phrenic nerve blockage have been reported. Here, we report a case of intractable hiccups that lasted five weeks in a 56-year-old male patient with a lung cancer above the right diaphragm. We hypothesized that his intractable hiccups were caused by irritation and mass effect caused by the lung cancer. We performed an ultrasound-guided right unilateral phrenic nerve pulsed radiofrequency treatment, and the patient's intractable hiccups were successfully managed without complication.
Diaphragm ; Hiccup* ; Humans ; Lung Neoplasms ; Lung* ; Male ; Middle Aged ; Phrenic Nerve ; Pulsed Radiofrequency Treatment ; Ultrasonography

OBJECTIVE: To evaluate the in vivo efficiency of the biopsy tract radiofrequency ablation for hemostasis after core biopsy of the liver in a porcine liver model, including situations with bleeding tendency and a larger (16-gauge) core needle. MATERIALS AND METHODS: A preliminary study was performed using one pig to determine optimal ablation parameters. For the main experiment, four pigs were assigned to different groups according to heparinization use and biopsy needle caliber. In each pig, 14 control (without tract ablation) and 14 experimental (tract ablation) ultrasound-guided core biopsies were performed using either an 18- or 16-gauge needle. Post-biopsy bleeding amounts were measured by soaking up the blood for five minutes. The results were compared using the Mann-Whitney U test. RESULTS: The optimal parameters for biopsy tract ablation were determined as a 2-cm active tip electrode set at 40-watt with a tip temperature of 70–80℃. The bleeding amounts in all experimental groups were smaller than those in the controls; however they were significant in the non-heparinized pig biopsied with an 18-gauge needle and in two heparinized pigs (p < 0.001). In the heparinized pigs, the mean blood loss in the experimental group was 3.5% and 13.5% of the controls biopsied with an 18- and 16-gauge needle, respectively. CONCLUSION: Radiofrequency ablation of hepatic core biopsy tract ablation may reduce post-biopsy bleeding even under bleeding tendency and using a larger core needle, according to the result from in vivo porcine model experiments.
Biopsy ; Biopsy, Large-Core Needle* ; Catheter Ablation ; Electrodes ; Hemorrhage* ; Hemostasis ; Heparin ; Liver* ; Needles ; Pulsed Radiofrequency Treatment ; Swine

Transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) has been reported to be effective for local control of different-sized hepatocellular carcinomas. However, it is unclear if these benefits could also be applicable to different-sized liver metastases from gastrointestinal cancers. The aim of this study was to evaluate the outcomes of TACE combined with RFA for liver metastases from gastrointestinal cancers. In this study, we retrospectively analyzed clinical data of 19 consecutive patients who had a total of 26 liver metastatic lesions from gastrointestinal cancers and underwent RFA followed by first-time TACE treatment. The tumor recurrence, overall survival rate and procedure-related complications were evaluated. Moreover, patients' demographics and tumor characteristics were analyzed to determine their impact on the outcomes. The technical success of TACE plus RFA was achieved with 2 major procedure-related complications found. The mean follow-up was 21.3 months. The total 1-, 2-, and 3-year survival rate was 89.4%, 52.6%, and 35.1%, respectively. It was found that the tumor size and the ratio of enhancement area were significant factors that influenced the overall survival. In conclusion, patients with gastrointestinal cancer-derived liver metastatic lesions of smaller size and larger enhancement area are considered appropriate candidates for TACE plus RFA.
Ablation Techniques ; adverse effects ; Adult ; Aged ; Aged, 80 and over ; Chemoembolization, Therapeutic ; adverse effects ; Female ; Gastrointestinal Neoplasms ; pathology ; therapy ; Humans ; Liver Neoplasms ; secondary ; therapy ; Male ; Middle Aged ; Pulsed Radiofrequency Treatment ; adverse effects ; Survival Analysis

The superficial peroneal nerve is vulnerable to damage from ankle sprain injuries and fractures as well as surgery to this region. And it is also one of the most commonly involved nerves in complex regional pain syndrome type II in the foot and ankle region. We report two cases of ultrasound-guided pulsed radiofrequency treatment of superficial peroneal nerve for reduction of allodynia in CRPS patients.
Ankle ; Ankle Injuries ; Causalgia ; Foot ; Humans ; Hyperalgesia* ; Neuralgia ; Peripheral Nerves ; Peroneal Nerve* ; Pulsed Radiofrequency Treatment* ; Ultrasonography

A nerve block is an effective tool for diagnostic and therapeutic methods. If a diagnostic nerve block is successful for pain relief and the subsequent therapeutic nerve block is effective for only a limited duration, the next step that should be considered is a nerve ablation or modulation. The nerve ablation causes iatrogenic neural degeneration aiming only for sensory or sympathetic denervation without motor deficits. Nerve ablation produces the interruption of axonal continuity, degeneration of nerve fibers distal to the lesion (Wallerian degeneration), and the eventual death of axotomized neurons. The nerve ablation methods currently available for resection/removal of innervation are performed by either chemical or thermal ablation. Meanwhile, the nerve modulation method for interruption of innervation is performed using an electromagnetic field of pulsed radiofrequency. According to Sunderland's classification, it is first and foremost suggested that current neural ablations produce third degree peripheral nerve injury (PNI) to the myelin, axon, and endoneurium without any disruption of the fascicular arrangement, perineurium, and epineurium. The merit of Sunderland's third degree PNI is to produce a reversible injury. However, its shortcoming is the recurrence of pain and the necessity of repeated ablative procedures. The molecular mechanisms related to axonal regeneration after injury include cross-talk between axons and glial cells, neurotrophic factors, extracellular matrix molecules, and their receptors. It is essential to establish a safe, long-standing denervation method without any complications in future practices based on the mechanisms of nerve degeneration as well as following regeneration.
Axons ; Classification ; Denervation ; Electromagnetic Fields ; Extracellular Matrix ; Myelin Sheath ; Nerve Block ; Nerve Degeneration ; Nerve Fibers ; Nerve Growth Factors ; Nerve Regeneration ; Neuroglia ; Neurons ; Peripheral Nerve Injuries ; Peripheral Nerves ; Pulsed Radiofrequency Treatment ; Recurrence ; Regeneration* ; Sympathectomy ; Wallerian Degeneration

OBJECTIVE: To investigate the comparative treatment effects of ultrasound-guided pulsed radiofrequency treatment (UG-PRF) in the gastrocnemius interfascial space and ultrasound-guided interfascial injection (UG-INJ) on myofascial pain syndrome. METHODS: Forty consecutive patients with myofascial pain syndrome of the gastrocnemius were enrolled and were allocated to one of the two groups. Twenty patients were treated by UG-PRF delivered to the gastrocnemius interfascial space (UG-PRF group) and the other 20 patients were treated by interfascial injection (UG-INJ group). The primary outcome measure was the numeric rating score (NRS) for pain on pressing the tender point in the gastrocnemius, and the secondary outcome measure was health-related quality of life as determined by the Short Form-36 questionnaire (SF-36). NRSs were obtained at the first visit, immediately after treatment, and at 2 and 4 weeks post-treatment, and physical component summary scores (PCS) and mental component summary scores (MCS) of the SF-36 questionnaire were measured at the first visit and at 4 weeks post-treatment. RESULTS: Immediately after treatments, mean NRS in the UG-PRF group was significantly higher than that in the UG-INJ group (p<0.0001). However, at 2 and 4 weeks post-treatment, the mean NRS was significantly lower in the UG-PRF group (both p<0.0001). Similarly, at 4 weeks post-treatment, mean PCS and MCS were significantly higher in the UG-PRF group (p<0.0001 and p=0.002, respectively). CONCLUSION: Based on these results, the authors conclude that ultrasound-guided gastrocnemius interfascial PRF provides an attractive treatment for myofascial pain syndrome of the gastrocnemius.
Humans ; Muscle, Skeletal ; Myofascial Pain Syndromes* ; Outcome Assessment (Health Care) ; Pulsed Radiofrequency Treatment ; Quality of Life