Pulsed radiofrequency for chronic pain.

Stanford University, 780 Welch Road #208, Palo Alto, CA 94304, USA.
Current Pain and Headache Reports (Impact Factor: 2.26). 02/2008; 12(1):37-41.
Source: PubMed

ABSTRACT Pulsed radiofrequency (PRF), a technology related to continuous radiofrequency, is unique in that it provides pain relief without causing significant damage to nervous tissue. The mechanism by which PRF controls pain is unclear, but it may involve a temperature-independent pathway mediated by a rapidly changing electrical field. Although much anecdotal evidence exists in favor of PRF, there are few quality studies substantiating its utility.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The management of patients with irreparable rotator cuff tears remains a challenge for orthopaedic surgeons with the final treatment option in many algorithms being either a reverse shoulder arthroplasty or a tendon transfer. The long term results of these procedures are however still widely debated, especially in younger patients. A variety of arthroscopic treatment options have been proposed for patients with an irreparable rotator cuff tear without the presence of arthritis of the glenohumeral joint. These include a simple debridement with or without a biceps tenotomy, partial rotator cuff repair with or without an interval slide, tuberplasty, graft interposition of the rotator cuff, suprascapular nerve ablation, superior capsule reconstruction and insertion of a biodegradable spacer (Inspace) to depress the humeral head. These options should be considered as part of the treatment algorithm in patients with an irreparable rotator cuff and could be used as either as an interim procedure, delaying the need for more invasive surgery in the physiologically young and active, or as potential definitive procedures in the medically unfit. The aim of this review is to highlight and summarise arthroscopic procedures and the results thereof currently utilised in the management of these challenging patients.
    World journal of orthopedics. 11/2014; 5(5):557-65.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Lumbosacral radicular pain is a common clinical finding with a statistical prevalence ranging from 9.9% to 25% in the general population. To investigate the effectiveness of dorsal root ganglion pulsed radiofrequency (PRF) in patients with chronic lumbosacral radicular pain and neuropathic features. Prospective case series clinical outcome study. We evaluated 34 patients with lumbosacral neuropathic pain who underwent PRF at the corresponding level of radicular symptoms distribution (ranging from L3 to S1). Each patient suffered a single leg-radiating pain with probable neuropathic features (assessed with clinical grading) lasting for > 6 months and unresponsive to previous treatments. A multifunctional PASHA-electrode® was introduced with trans-sacral access through a hollow needle, placed under fluoroscopic guidance into the lumbosacral epidural space and its active tip moved close to the dorsal root ganglion responsible of the clinical symptoms. After connecting the electrode to a generator, stimulation tests were performed and PRF was started and applied for 240 seconds at a frequency of 2Hz, amplitude of 45 V and a tip temperature between 40 - 42°C. If the pain involved more than a single nerve root, the electrode was placed at a different segment and the procedure repeated. Outcome measures included the pain intensity score on a 0 - 10 numeric rating scale (NRS) and the Italian Pain Questionnaire (QUID) at pre-treatment, one and 6 months post-treatment. P values < 0.05 were considered statistically significant. In comparison with pre-treatment, a significant reduction in pain score was observed in mean NRS either at one and 6 months (P < 0.001). The QUID - Pain Rating Index rank displayed a parallel trend at the first (P < 0.001) and last follow-up (P = 0.01). Moreover, a direct correlation between the 2 scales occurred, showing a parallel score decreasing (P < 0.001). Eighteen (52.9%) and 17 (50%) of 34 patients showed pain reduction in NRS > 2 points and > 30%, at one and 6 months, respectively. The non-controlled design of the study, the patients were heterogeneous, the small number of patients, and the duration of follow-up was limited to 6 months. PRF of dorsal root ganglion performed with a multifunctional electrode for > 240 seconds appears to be safe and might be more effective than the classic 120 seconds needle-mediated approach. Therefore, it may be considered as a valuable tool for the treatment of lumbosacral radicular pain with neuropathic features.
    Pain physician 12/2014; 17(6):477-86. · 4.77 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This paper presents a bipolar porous probe for implantable nerve stimulation treatment utilizing minimally invasive surgery. The probe's design features micro-wings and pores for cell growth that promote long term fixation in the body. Two recording pairs detect whether cells grow into the pores, and one pair of stimulating pads stimulates the target nerve. The probe is composed of three layers: two SU-8 layers and one flexible printed circuit (FPC) layer. Results show that SU-8 films can increase the product of the area moment of inertia and Young's Modulus by 9.04% from 5.86×10-6 N·m2 to 6.93×10-6 N·m2 and that micro-wings can increase the force of fixation by 38.58% from 0.114 N to 0.158 N. From the impedance test, the impedance of the pores in gelatin is shown to be lower than the ones in air, demonstrating that the two recording pairs are promising for detecting cells growth.
    2014 IEEE 27th International Conference on Micro Electro Mechanical Systems (MEMS); 01/2014


Available from