|
KMID : 0614520020120010084
|
|
Journal of the Korean Pain Research Society
2002 Volume.12 No. 1 p.84 ~ p.94
|
|
|
Role of Nerve Block and Radiofrequency Treatment in Management of Chronic Refractory Spinal Pain in Elderly Patients
|
|
Park Dong-Hyuk
Lee Jin-Hoon
Park Jung-Yul
Kim Se-Hoon
Lim Dong-Jun
Lee Ki-Chan
|
|
|
Abstract
|
|
|
|
The posterior zygapophyseal joints of the spine, which are innervated by medial branch of posterior primary ramus (PPR) have long been considered responsible for some cases of mechanical neck and low back pain. On the other hand, to interrupt nociceptive stimuli from a segmental region rather than from a specific structure, such as the zygapophysial joint, lesioning at the level of the dorsal root ganglion (DRG) can be produced. The present study was conducted to establish, in the elderly patient population who suffered from chronic pain of spinal origin, the benefit of radiofrequency (RF) denervation of involved neural structures as a treatment for the relief of pain and recovery of functional disabilities. In addition, the effect of therapeutic nerve block with local anesthetics and steroid was investigated to verify its efficacy and role in these clinical settings. Prospectively, a total of 106 consecutive patients with chronic neck or back pain were selected for diagnostic or therapeutic nerve block followed by RF pain therapy between October, 2000 and August, 2001 to our clinic. As a result, 106 patients underwent nerve block with local anesthetics and steroid during the period of this study. If symptoms and signs recurred after initial substantial pain relief (≥50% pain reduction), they underwent a RF nerve block. Of these 106 patients, 38 underwent RF treatment of the PPR or/and DRG or sympathetic nerve for definitive, long-term control of recurrent or remaining persistent pain. For the therapeutic effect of nerve block with local anesthetics and steroid, 28 of 51 (55%) patients were good to excellent pain relief at 6 months of follow-up. Of 38 patients who underwent RF procedures following the nerve blocks, at 1 month, 26 of 38 (68%) patients reported good to excellent pain relief. Similar results were observed at three months and 16 of 25 (64%) patients still showed good to excellent pain relief at six months of follow-up period. There were no significant complications associated with these procedures. These results indicate that nerve blocks and RF treatment provide substantial pain relief with many advantages, such as good efficacy, simplicity and safety of the procedure, repeatability, minimal stay in hospital, long duration of pain relief and the feasibility of procedure. Thus, first of all, these minimal invasive procedures would be recommended in aged patients with chronic neck or back pain that are not controlled with conservative managements and not suitable for surgery.
|
|
|
KEYWORD
|
|
|
Elderly, Nerve block, Radiofrequency, Lesioning, Pain
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|