title: Radiofrequency neurolysis in the management of inguinal neuralgia: preliminary study.
abstract: OBJECTIVE
  To evaluate the feasibility and efficacy of computed tomography (CT)-guided radiofrequency (RF) neurolysis (RFN) in the management of refractory inguinal neuralgia.
  
  
  METHODS
  Local institutional review board approval was obtained and written informed consent was waived. Twelve patients 26-75 years of age with chronic (>6 months) inguinal pain refractory to specific medication were included between 2005 and 2011. Data on patient demographics, clinical history, and pain management history were retrospectively assessed. Pain was measured on a visual analog scale (VAS) from 0 to 10 before and immediately after the procedure and at 1, 3, 6, 9 and 12 months. Diagnosis was always confirmed by a positive nerve block test result. Ambulatory CT-guided RF was the rule.
  
  
  RESULTS
  Sixteen RFN procedures were performed. Pain was present for an average of 3.2 years (range: 2-8 years) prior to initial RFN. Mean VAS score before the procedure was 7.75 of 10. Immediate pain relief of 100% was achieved in all patients. Pain reduction at 1-, 3-, 6-, 9-, and 12-month follow-up was statistically significant. Important pain reduction (≥80%) was obtained in 75% of RFN procedures at 6-month follow-up and in 50% of cases at 12 months. The mean duration of pain relief was 11.8 months after RFN, with a maximum average pain reduction of 84.5%. No complications were noted during or after the procedure.
  
  
  CONCLUSIONS
  RFN with CT guidance is an effective technique in the management of refractory inguinal pain with lasting satisfactory pain reduction; it may be considered as an alternative treatment to surgery. These results should be confirmed in a controlled trial with a larger series of patients.
authors.affiliation: Department of Radiology, Hôpital Gabriel Montpied CHU Clermont-Ferrand, 58 Rue Montalembert, F-63000 Clermont-Ferrand, France. adriankastler@gmail.com
authors.forename: Adrian
authors.initials: A
authors.lastname: Kastler
authors.forename: Sébastien
authors.initials: S
authors.lastname: Aubry
authors.forename: Benoît
authors.initials: B
authors.lastname: Barbier-Brion
authors.forename: Jérôme
authors.initials: J
authors.lastname: Jehl
authors.forename: Bruno
authors.initials: B
authors.lastname: Kastler
mesh_terms: D000328:Adult; D000368:Aged; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007264:Inguinal Canal; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D010865:Pilot Projects; D000078702:Radiofrequency Therapy; D015641:Radiography, Interventional / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome