Effects and side effects of a percutaneous thermal lesion of the dorsal root ganglion in patients with cervical pain syndrome.
Twenty consecutive patients with intractable chronic pain in the cervical region were treated with a radiofrequency lesion of the dorsal root ganglion on level C4, C5 or C6. Electromyography (EMG) and sensory evoked potentials (SEP) were recorded before and 3 weeks after the radiofrequency lesion. Side effects were studied 3 weeks, 6 weeks and 3 months after the procedure. Pain scores were evaluated on Numeric Rating Scales (NRS) before and 6 weeks after treatment. The patient was interviewed 3, 6 and 9 months after the radiofrequency lesion. The most common side effect was burning pain in the dermatome of the treated nerve root. Hyposensibility in the dermatome was noticed in 35% of patients. Except in 1 patient, these side effects had disappeared 6 weeks after treatment. The EMG showed no signs of denervation. One SEP recording remained abnormal after treatment. There was initial pain relief in 75% of patients after 3 months and in 50% of the patients after 6 months. In conclusion, this study did not reveal any signs of motor denervation after a percutaneous partial rhizotomy. There were no long-term signs of deafferentation. Initial pain relief was found in 75% of patients, but there was a marked tendency for pain to recur in a period from 3 to 9 months after treatment.
van Kleef
M
M
Departments of Anaesthesiology and Pain Relief, University Hospital, MaastrichtThe Netherlands Departments of Clinical Neurophysiology, University Hospital, MaastrichtThe Netherlands.
Spaans
F
F
Dingemans
W
W
Barendse
G A M
GAM
Floor
E
E
Sluijter
M E
ME
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004576:Electromyography; D005073:Evoked Potentials, Somatosensory; D005260:Female; D005500:Follow-Up Studies; D005727:Ganglia, Spinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D011859:Radiography; D016634:Radiosurgery / Q000009:adverse effects; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000628:therapy*