ABSTRACT
Radiation safety of fluoroscopy is gold standard for chronic pain interventions but radiation exposure risk is still the main issue with its use. The aim of this study was to compare the efficacy of ultrasound-guided caudal pulsed radiofrequency (USCPRF) with fluoroscopy guided caudal pulsed radiofrequency (FCPRF) for patients with peripheral neuropathy (PNP). A caudal pulsed radiofrequency (CPRF) for 56 patients with PNP and randomly assigned to either the ultrasound (US) -guided or the fluoroscopy (FL) -guided group. The pain evaluate was measured by patients’ ratings of a 10-point numerical pain scale (NPS) before and 2 days, 30 days, and 120 days after treatments. The blocking procedures were well tolerated, and comparable pain relieving effects appeared. The pain intensity, as measured by NPS, significantly decreased at 2 days, 30 days and 120 days after CPRF in both US and FL groups, respectively, compared with that of baseline (P < 0.05). There was same result in in both approach, US-guided and FL-guided. Ultrasonography can be an alternative method for its convenience and efficacy in CPRF for PNP patients, with shorting time and no exposed to radiation.
Reference
- [1] Attal N, Cruccu G, Baron R, et al. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010 Sep; 17(9):1113–e1188.
- [2] Callaghan BC, Burke JF, Rodgers A, et al. Expenditures in the elderly with peripheral neuropathy: Where should we focus cost-control efforts? Neurology. Clinical practice. 2013 Oct;3(5):421–430.
- [3] Callaghan BC, Kerber K, Smith AL, Fendrick AM, Feldman EL. The evaluation of distal symmetric polyneuropathy: a physician survey of clinical practice. Archives of Neurology. 2012 Mar;69(3):339–345.
- [4] Smith AG, Singleton JR. The diagnostic yield of a standardized approach to idiopathic sensory-predominant neuropathy. Archives of internal medicine. 2004 May 10;164(9):1021–1025.
- [5] Sluijter ME, Teixeira A, Serra V, Balogh S, Schianchi P. Intra-articular application of pulsed radiofrequency for arthrogenic pain–report of six cases. Pain Pract 2008; 8:57-61.
- [6] Callaghan BC, Kerber KA, Lisabeth LL, et al. Role of neurologists and diagnostic tests on the management of distal symmetric polyneuropathy. JAMA Neurology. 2014 Sep;71(9):1143–1149.
- Nakahashi M, Uei H, Hoshino M, Omori K, Igarashi H, Tokuhashi Y. Anatomical evaluation of the sacral hiatus using ultrasound imaging: factors that inhibit needle insertion during caudal epidural block procedures. Pain Pract 2020;20:55–61. https://doi.org/10.1111/papr.12826.
- [8] Erdine S, Bilir A, Cosman ER, Cosman Jr ER. Ultrastructural changes in axons following exposure to pulsed radiofrequency fields. Pain Pract 2009;9:407–17. https://doi.org/10.1111/j.1533-2500.2009.00317.x
- [9] Arsanious D, Gage E, Koning J, Sarhan M, Chaiban G, Almualim M, Atallah J. Pulsed dose radiofrequency before ablation of medial branch of the lumbar dorsal ramus for zygapophyseal joint pain reduces post-procedural pain. Pain Physician 2016; 19:477-484.
- Chang MC, Cho YW, Ahn SH. Comparison between bipolar pulsed radiofrequency and monopolar pulsed radiofrequency in chronic lumbosacral radicular pain: A randomized controlled trial. Medicine (Baltimore) 2017; 96:e6236.
- Di Cesare Mannelli L, Pacini A, Bonaccini L, Zanardelli M, Mello T, Ghelardini C. Morphologic features and glial activation in rat oxaliplatin-dependent neuropathic pain. J Pain 2013; 14:1585-1600.
- Choi GS, Ahn SH, Cho YW, Lee DG. Long-term effect of pulsed radiofrequency on chronic cervical radicular pain refractory to repeated transforaminal epidural steroid injections. Pain Med 2012; 13:368-375.
Download all article in PDF
