• The Korean Journal of Pain
• /
• v.19 no.2
• /
• pp.244-248
• /
• 2006

Radiofrequency lesioning is a valuable tool for third occipital headache. Relative to most neural targets, a radiofrequency lesion is very small. Reliable pre-operative diagnosis of the nociceptive source is critical, as inappropriately placed lesions will not modulate pain. Knowledge of the anatomical courses of nerves and extremely precise electrode placement are required for accurate lesioning. This report describes our experience with RF lesioning in the treatment of chronic pain in two patients who suffered from third occipital headaches. In one patient, satisfactory improvement of the pain was observed after 10 months of follow up.

• The Korean Journal of Pain
• /
• v.26 no.2
• /
• pp.186-190
• /
• 2013

A C2-3 zygapophygeal joint is a major source of cervicogenic headache. Radiofrequency (RF) neurotomy is preformed widely for zygapophygeal joint pain. Conventional RF denervation technique is generally performed under fluoroscopic control. Recently, ultrasound-guided radiofrequency on zygapophygeal joint has emerged as an alternative method. We report our experiences of two successful ultrasound-guided pulsed radiofrequencies on 39-year-old and 42-year-old males, who complained occipital headache and posterior neck pain.

• The Korean Journal of Pain
• /
• v.30 no.4
• /
• pp.296-303
• /
• 2017

Background: To achieve a prolonged therapeutic effect in patients with lumbar facet joint syndrome, radiofrequency medial branch neurotomy (RF-MB) is commonly performed. The purpose of this study was to evaluate the prognostic value of paravertebral muscle twitching when performing RF-MB in patients with lumbar facet joint syndrome. Methods: We collected and analyzed data from 68 patients with confirmed facet joint syndrome. Sensory stimulation was performed at 50 Hz with a 0.5 V cut-off value. Patients were divided into 3 groups according to the twitching of the paravertebral muscle during 2 Hz motor stimulation: 'Complete', when twitching was observed at all needles; 'Partial', when twitching was present at 1 or 2 needles; and 'None', when no twitching was observed. The relationship between the long-term effects of RF-MB and paravertebral muscle twitching was analyzed. Results: The mean effect duration of RF-MB was 4.6, 5.8, and 7.0 months in the None, Partial, and Complete groups, respectively (P = 0.47). Although the mean effect duration of RF-MB did not increase significantly in proportion to the paravertebral muscle twitching, the Complete group had prolonged effect duration (> 6 months) than the None group in subgroup analysis. (P = 0.03). Conclusions: Paravertebral muscle twitching while performing lumbar RF-MB may be a reliable predictor of long-term efficacy when sensory provocation under 0.5 V is achieved. However, further investigation may be necessary for clarifying its clinical significance.

• The Korean Journal of Pain
• /
• v.18 no.2
• /
• pp.263-266
• /
• 2005

The ganglion impar is a solitary retroperitoneal structure at the caudal end of the paravertebral sympathetic chain. Block of this ganglion has been advocated as a means of managing intractable perineal pain. In 1990, Plancarte et al performed a neurolytic block of the ganglion impar using 4-6 ml of 10% phenol through the intergluteal skin over the anococcygeal ligament. However, technical difficulties are encountered with the placement of the needle while performing this technique, with complications from the injection of phenol also being a possibility. In 1995, a modified approach for blocking the ganglion impar through the sacrococcygeal ligament was introduced by Wemm and Saberski. We used a radiofrequency (RF) lesion generator to create a controlled and localized lesion with a lower incidence of neural damages compared to chemical neurolysis. RF thermocoagulation of the ganglion impar through the sacrococcygeal ligament was performed on a 70-year-old male patient with constant anal pain using a curved TEW electrode. The patient has been relieved of his pain, without serious complication. Therefore, this technique may be an easier and safer approach, which is associated with fewer chances of complications.