The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Clinical Effects of Fluoroscopy Guided Interventional Microadhesiolysis and Nerve Stimulation (FIMS) on Cervical Zygapophyseal Joints in Patients with Chronic Cervical Radicular Pain

경추성 방사통을 가진 만성통증환자에서 경추 후관절에 대한 투시영상하 중재적 미세유착 박리 및 신경자극요법의 임상적 효과

  • Kim, Eun Ha (Department of Chronic Pain Management Center, CHA Genral Hospital, Pochon CHA University College of Medicine)
  • 김은하 (포천중문대학교 의과대학 강남차병원 만성통증센터)
  • Received : 2007.05.10
  • Accepted : 2007.06.18
  • Published : 2007.06.30
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Abstract

Background: Cervical radicular pain can arise fromvarious structures, including spinal nerves, discs, zygapophyseal joints, ligaments, and myofascial connective tissue. However, no adequate experiments have been found regarding methods for the microadhesiolysis of adhesional connective tissue around the zygapophyseal joints and nerves. The first objective of this study was to ascertain the effect of fluoroscopy guided interventional microadhesiolysis and nerve stimulation (FIMS) on chronic cervical radicular pain caused by zygapophyseal joint dysfunction. The second objective was to identify the duration of pain alleviation, as well as commonly occurring regions for zygapophyseal joint dysfunction. Methods: Twenty-eight patients were diagnosed with cervical radicular pain. The cervical zygapophyseal joints and adhesional structures around the cervical zygapophyseal joints were stimulated by adhesiolysis with a rounded needle; the procedure was performed once every second week. A visual analogue scale (VAS) for pain and neck range of motion (ROM) were used as indices for evaluating the degree of pain 1 and 3 months after completion of the procedures. A relief effect of FIMS was accepted when the VAS index decreased 50% compared with a previous VAS, and when there was absence of limitation of ROM. Results: Among the patients, 52% showed zygapophyseal joint dysfunction in C5-6, 38% in C4-5, 7% in C2-3, and 3% in C6-7. After performing FIMS, the VAS index decreased in most of the patients after 1 and 3 months (92.8% and 75%, respectively), and treatment frequency was $2.7{\pm}1.2$. There was no correlation between the number of FIMS procedures and the degree of VAS. Conclusions: FIMS is considered an effective modality in patients suffering from cervical radicular pain.

Keywords

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