Radiofrequency procedures in chronic pain.
Radiofrequency current is simply a tool used for creating discrete thermal lesions in neural pathways in order to interrupt transmission. In pain medicine, radiofrequency lesions have been used to interrupt nociceptive pathways at various sites. This is a palliative treatment not without complications, so its use should be limited to those patients with cancer pain or chronic non-cancer pain for whom conservative non-surgical therapies have been ineffective or intolerable. With the development of alternatives such as intrathecal opioid infusion and neuromodulation technologies, the number of patients considered for neuroablative therapy may dwindle. Nevertheless, there is evidence that radiofrequency neurotomy has an important role in the management of trigeminal neuralgia, nerve root avulsion and spinal pain. In this chapter the evidence for efficacy and safety is reviewed and interrogated with special emphasis on the available randomized controlled trails and systematic review.
Lord
Susan M
SM
Division of Anaesthesia, Intensive Care & Pain Management, John Hunter Hospital, Locked Bag 1, Hunter Region Mail Centre, New South Wales 2310, Australia.
Bogduk
Nikolai
N
D017115:Catheter Ablation / Q000379:methods*; D002908:Chronic Disease; D004594:Electrophysiology; D006801:Humans; D010146:Pain / Q000503:physiopathology / Q000601:surgery*; D019051:Rhizotomy / Q000379:methods; D013126:Spinal Nerve Roots / Q000503:physiopathology / Q000601:surgery; D013131:Spine / Q000294:innervation / Q000601:surgery; D014277:Trigeminal Neuralgia / Q000503:physiopathology / Q000601:surgery; D021801:Zygapophyseal Joint / Q000294:innervation / Q000601:surgery