Radiofrequency lesioning techniques in the management of chronic pain |
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| Affiliation: | 1. Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA;2. Department of Orthopedic Surgery, Stanford University School of Medicine, Stanford, California, USA;1. State Key Laboratory of Molecular Biology, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, University of Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China;2. State Key Laboratory of Agrobiotechnology, China Agricultural University, Beijing 100193, China;3. Shanghai Institute of Immunology, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China;1. Department of Pharmacology, UT Southwestern Medical Center, Dallas, TX, USA;2. Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX, USA;3. Instituto de Investigaciones en Medicina Traslacional, CONICET, Universidad Austral, Argentina;4. Division of Translational Oncology, Essen University Hospital, German Cancer Consortium (DKTK), Partner Site Essen and German Cancer Research Center (DKFZ), Heidelberg, Germany |
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| Abstract: | Radiofrequency lesioning is used in pain management as a means of denervating a painful structure by generating a thermal lesion within a sensory nerve or sensory pathway of the CNS. Radiofrequency lesioning apparatus uses a radiofrequency source to apply a current to an insulated needle with an exposed tip. A radiofrequency current applied to the needle causes a zone of heating around the uninsulated part of the needle. The tissue is heated not the needle, therefore the needle has to be placed adjacent and parallel to a nerve rather than perpendicular to it. Data from randomized trials or large open series support the use of radiofrequency lesioning in lumbar facet arthropathy, cervical facet arthropathy, trigeminal neuralgia, unilateral cancer pain (e.g. mesothelioma), segmental cancer pain, discogenic low back pain, and sympathetically mediated pain. The safety of percutaneous radiofrequency lesioning compares favourably with many of the techniques it has supplanted. However possible complications include unintentional nerve injury and peripheral and central neuropathic pain. |
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