The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Pulsed Radiofrequency Application for the Treatment of Pain Secondary to Sacroiliac Joint Metastases

  • Yi, Yu Ri (Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University) ;
  • Lee, Na Rea (Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University) ;
  • Kwon, Young Suk (Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University) ;
  • Jang, Ji Su (Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University) ;
  • Lim, So Young (Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University)
  • Received : 2015.09.07
  • Accepted : 2015.10.20
  • Published : 2016.01.01
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Abstract

Sacroiliac (SI) joint pain can result from degeneration, infection, malignancy, and trauma. Patients with metastatic bone pain who do not respond to conventional treatment may need more aggressive neuroinvasive approaches. Recently, pulsed radiofrequency (PRF) neuromodulation has emerged as a promising treatment alternative for refractory cases of SI joint pain. Nevertheless, there is no report on the treatment of pain arising from SI joint metastases with PRF. We are reporting about a 63-year-old woman suffering from buttock pain due to breast cancer metastases in the SI joint. We treated this patient with PRF neuromodulation of the L4-S3 primary dorsal rami and lateral branches using a rotating curved needle technique. The patient tolerated the procedures well, without any complications. She experienced about 70% reduction in pain, and pain relief was sustained for 10 months. This result suggests that PRF neuromodulation is a safe, effective treatment for pain from SI joint metastases.

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References

  1. Raque GH Jr, Vitaz TW, Shields CB. Treatment of neoplastic diseases of the sacrum. J Surg Oncol 2001; 76: 301-7. https://doi.org/10.1002/jso.1050
  2. Mercadante S, Fulfaro F. Management of painful bone metastases. Curr Opin Oncol 2007; 19: 308-14. https://doi.org/10.1097/CCO.0b013e3281214400
  3. Chua NH, Vissers KC, Sluijter ME. Pulsed radiofrequency treatment in interventional pain management: mechanisms and potential indications-a review. Acta Neurochir (Wien) 2011; 153: 763-71. https://doi.org/10.1007/s00701-010-0881-5
  4. Vallejo R, Benyamin RM, Kramer J, Stanton G, Joseph NJ. Pulsed radiofrequency denervation for the treatment of sacroiliac joint syndrome. Pain Med 2006; 7: 429-34. https://doi.org/10.1111/j.1526-4637.2006.00143.x
  5. Ripamonti C, Fulfaro F. Malignant bone pain: pathophysiology and treatments. Curr Rev Pain 2000; 4: 187-96. https://doi.org/10.1007/s11916-000-0078-3
  6. Ramasubba C, Cohen SP. Cooled sacroiliac radiofrequency denervation for the treatment of pain secondary to tumor infiltration: a case-based focused literature review. Pain Physician 2013; 16: 1-8.
  7. Cahana A, Van Zundert J, Macrea L, van Kleef M, Sluijter M. Pulsed radiofrequency: current clinical and biological literature available. Pain Med 2006; 7: 411-23. https://doi.org/10.1111/j.1526-4637.2006.00148.x
  8. Podhajsky RJ, Sekiguchi Y, Kikuchi S, Myers RR. The histologic effects of pulsed and continuous radiofrequency lesions at 42 degrees C to rat dorsal root ganglion and sciatic nerve. Spine (Phila Pa 1976) 2005; 30: 1008-13. https://doi.org/10.1097/01.brs.0000161005.31398.58
  9. Zeldin A, Ioscovich A. Pulsed radiofrequency for metastatic pain treatment. Pain Physician 2008; 11: 921-2.
  10. Cohen SP, Strassels SA, Kurihara C, Crooks MT, Erdek MA, Forsythe A, et al. Outcome predictors for sacroiliac joint (lateral branch) radiofrequency denervation. Reg Anesth Pain Med 2009; 34: 206-14. https://doi.org/10.1097/AAP.0b013e3181958f4b
  11. Cohen SP, Hurley RW, Buckenmaier CC 3rd, Kurihara C, Morlando B, Dragovich A. Randomized placebo-controlled study evaluating lateral branch radiofrequency denervation for sacroiliac joint pain. Anesthesiology 2008; 109: 279-88. https://doi.org/10.1097/ALN.0b013e31817f4c7c
  12. Karaman H, Kavak GO, Tufek A, Celik F, Yildirim ZB, Akdemir MS, et al. Cooled radiofrequency application for treatment of sacroiliac joint pain. Acta Neurochir (Wien) 2011; 153: 1461-8. https://doi.org/10.1007/s00701-011-1003-8
  13. Gofeld M, Faclier G. Radiofrequency denervation of the lumbar zygapophysial joints--targeting the best practice. Pain Med 2008; 9: 204-11. https://doi.org/10.1111/j.1526-4637.2007.00345.x
  14. Racz GB, Stanton-Hicks M. Lumbar and thoracic sympathetic radiofrequency lesioning in complex regional pain syndrome. Pain Pract 2002; 2: 250-6. https://doi.org/10.1046/j.1533-2500.2002.02032.x

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