• The Korean Journal of Pain
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• 제25권3호
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• pp.155-160
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• 2012

Background: We have developed an intradiscal pulsed radiofrequency (Disc PRF) technique, using Diskit $II^{(R)}$ needles (NeuroTherm, Wilmington, MA, USA), as a minimally invasive treatment option for chronic discogenic low back pain (LBP). The purpose of this study was to compare the representative outcomes of Disc PRF and Intradiscal Electrothermal Therapy (IDET) in terms of pain relief and reduction of disability. Methods: Thirty-one patients with chronic discogenic LBP who underwent either Disc PRF (n = 15) or IDET (n = 16) were enrolled in the study. A Diskit $II^{(R)}$ needle (15-cm length, 20-gauge needle with a 20-mm active tip) was placed centrally in the disc. PRF was applied for 15 min at a setting of $5{\times}50$ ms/s and 60 V. The pain intensity score on a 0-10 numeric rating scale (NRS) and the Roland-Morris Disability Questionnaire (RMDQ) were assessed pretreatment and at 1, 3, and 6 months post-treatment. Results: The mean NRS was significantly improved from $7.2{\pm}0.6$ pretreatment to$2.5{\pm}0.9$ in the Disc PRF group, and from $7.5{\pm}1.0$ to $1.7{\pm}1.5$ in the IDET group, at the 6-month follow-up. The mean RMDQ also showed significant improvement in both the Disc PRF group and the IDET group at the 6-month follow-up. There were no significant differences in the pretreatment NRS and RMDQ scores between the groups. Conclusions: Disc PRF appears to be an alternative to IDET as a safe, minimally invasive treatment option for patients with chronic discogenic LBP.

• Korean Journal of Radiology
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• 제19권6호
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• pp.1130-1139
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• 2018

Objective: To compare the therapeutic efficacy between conventional transarterial chemoembolization (cTACE) and combined therapy using cTACE and radiofrequency ablation (RFA) in ultrasound (US)-invisible early stage hepatocellular carcinoma (HCC). Materials and Methods: From January 2008 to June 2016, 167 patients with US-invisible early stage HCCs were treated with cTACE alone (cTACE group; n = 85) or cTACE followed by immediate fluoroscopy-guided RFA targeting intratumoral iodized oil retention (combined group; n = 82). Procedure-related complications, local tumor progression (LTP), time to progression (TTP), and overall survival (OS) were compared between the two groups. Multivariate analyses were performed to identify prognostic factors. Results: There was no major complication in either group. The cTACE group showed higher 1-, 3-, and 5-year LTP rates than the combined group; i.e., 12.5%, 31.7%, and 37.0%, respectively, in the cTACE group; compared to 7.3%, 16.5%, and 16.5%, respectively, in the combined group; p = 0.013. The median TTP was 18 months in the cTACE group and 24 months in the combined group (p = 0.037). Cumulative 1-, 3-, and 5-year OS rates were 100%, 93.2%, and 87.7%, respectively, in the cTACE group and 100%, 96.6%, and 87.4%, respectively, in the combined group (p = 0.686). Tumor diameter > 20 mm and cTACE monotherapy were independent risk factors for LTP and TTP. Conclusion: Combined therapy using cTACE followed by fluoroscopy-guided RFA is a safe and effective treatment in US-invisible early stage HCCs. It provides less LTP and longer TTP than cTACE alone.

• The Korean Journal of Pain
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• 제26권3호
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• pp.223-241
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• 2013

Boney metastasis may lead to terrible suffering from debilitating pain. The most likely malignancies that spread to bone are prostate, breast, and lung. Painful osseous metastases are typically associated with multiple episodes of breakthrough pain which may occur with activities of daily living, weight bearing, lifting, coughing, and sneezing. Almost half of these breakthrough pain episodes are rapid in onset and short in duration and 44% of episodes are unpredictable. Treatment strategies include: analgesic approaches with "triple opioid therapy", bisphosphonates, chemotherapeutic agents, hormonal therapy, interventional and surgical approaches, steroids, radiation (external beam radiation, radiopharmaceuticals), ablative techniques (radiofrequency ablation, cryoablation), and intrathecal analgesics.

• Journal of Gastric Cancer
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• 제9권1호
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• pp.10-13
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• 2009

위암의 간전이는 수술적 절제, 전신적 항암약물요법, 간동 맥색전술 등의 여러 가지 치료방법이 사용되고 있으나 예후가 매우 불량하여 아직까지 표준치료방법이 정립되어 있지 않은 상황이다. 최근 간암 등에서 많이 사용되고 있는 고주파열치료(Radiofrequency)가 위암의 간전이 치료방법으로 시도되고 있으나, 아직까지 문헌에 보고된 예는 많지 않아 정확한 치료성적을 판단할 수는 없으나 기존의 수술적 방법에 비교하여 유사한 성적을 보임으로써 위암의 간전이 치료의 새로운 치료방법으로 대두되고 있다. 고주파 열치료의 치료성적을 정확히 평가하기 위하여 위암의 간전이 환자에 대한 전향적 연구가 필요한 실정이다.

• Journal of Hospice and Palliative Care
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• 제21권3호
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• pp.104-107
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• 2018

딸꾹질은 대개의 경우에는 특별한 처치 없이도 고식적인 방법으로 멈추지만, 한 달 이상 지속되는 지속성 딸꾹질은 생명을 위협할 정도의 심각한 부작용을 초래한다. 특히 정확한 치료방법 또한 확립되어 있지 않고, 몇몇 보고에서 양측 횡격막 신경차단이 보고되어 있을 뿐이다. 56세 남환의 우측 횡격막을 침범한 말기폐암환자에서 발생한 난치성 지속성 딸꾹질에 대해 박동성 고주파술을 시행하여 좋은 치료 결과를 얻은 바, 문헌고찰과 함께 보고하고자 한다.

• The Korean Journal of Pain
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• 제20권2호
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• pp.195-198
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• 2007

A cluster headache is characterized by the occurrence of strictly unilateral and periocular pain with no side shift and ipsilateral oculofacial autonomic symptoms such as conjunctival injection, lacrimation, rhinorrhea and miosis. Cluster headache involves the activation of parasympathetic nerve structures located within the sphenopalatine ganglion, and blockade of the sphenopalatine ganglion has been shown to be effective at the treatment of cluster headaches that are resistant to conventional therapy. Herein, we describe a case of a 50-year-old male with a cluster headache that could not be controlled by conventional treatments who showed improvement after being treated with sphenopalatine ganglion pulsed radiofrequency.

• Korean Journal of Radiology
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• 제24권8호
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• pp.719-728
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• 2023

Radiofrequency ablation (RFA) has been widely used to manage hepatocellular carcinomas (HCCs) equal to or smaller than 3 cm. No-touch RFA has gained attention and has recently been implemented in local ablation therapy for HCCs, despite its technical complexity, as it provides improved local tumor control compared to conventional tumor-puncturing RFA. This article presents the practice guidelines for performing no-touch RFA for HCCs, which have been endorsed by the Korean Society of Image-Guided Tumor Ablation (KSITA). The guidelines are primarily designed to assist interventional oncologists and address the limitations of conventional tumor-puncturing RFA with describing the fundamental principles, various energy delivery methods, and clinical outcomes of no-touch RFA. The clinical outcomes include technical feasibility, local tumor progression rates, survival outcomes, and potential complications.

• The Journal of Korean Physical Therapy
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• 제23권6호
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• pp.31-36
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• 2011

Purpose: This pilot case series study aimed to evaluate the efficacy of continuous radiofrequency (CRF) application on dorsal root ganglia (DRG) to reduce spasticity of spinal cord lesion (SCL) patients. Methods: We performed CRF procedures on DRG in 8 subjects (7 males; mean age 39 years, range 31-53 years) with intractable spasticity that impeded activities of daily living and caregiving, although they had maximal tolerable doses of anti-spastic medications and active rehabilitative treatment. All subjects underwent CRF (90 seconds at $90^{\circ}C$) at multiple lumbosacral and/or cervical DRG. Muscle tone of the extremities was measured by the modified Ashworth scale (MAS) before and one month after procedures. Functional goals were established at baseline, and subjects' satisfaction levels were categorized one month after procedures. Results: A total of 54 CRF treatments were performed in 8 patients. In all patients, we found some improvement in muscle tone measured by the MAS. Six patients reported themselves satisfied with their current status at one month's post-treatment, and 2 patients were fairly satisfied with their gait pattern. In 3 patients, neuropathic pain was present after CRF on DRG. In 1 lumbar case, the pain subsided after several days, and the other 2 cervical cases suffered from tolerable neuropathic pain treated with anti-convulsant medication. Conclusion: CRF on DRG might be a promising alternative treatment to reduce spasticity in SCL patients. Further well-designed clinical trials on the efficacy and safety of CRF application on DRG are needed.

• The Korean Journal of Pain
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• 제35권4호
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• pp.447-457
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• 2022

Background: Ultrasound-guided genicular nerve radiofrequency (RF) procedures are of interest in the management of chronic knee pain. A wide variety of demographic, clinical, and procedural characteristics can affect treatment success. This study aimed to determine predictive factors to provide superior treatment outcomes. Methods: The demographic, clinical, and technical data of patients who received genicular nerve RF for knee pain between September 2016 and September 2021 were evaluated. A positive outcome was defined as at least 50% pain relief on a pain score for at least 6 months. Logistic regression analysis was performed to determine the factors associated with a successful response to genicular RF. Results: Among 206 patients who underwent genicular RF, 62% of the patients reported successful outcomes at 6 months. In the multivariate model, targeting 5 nerves (odds ratio [OR], 6.184; 95% confidence interval [CI], 2.291-16.690; P < 0.001) was the most significant predictor of successful outcomes. Multivariable logistic regression analysis showed that prognostic genicular nerve block with a 50% cut-off value (OR, 2.109; 95% CI, 1.038-4.287; P = 0.039), no opioid use (OR, 2.753; 95% CI, 1.405-5.393; P = 0.003), and depression (OR, 0.297; 95% CI, 0.124-0.713; P = 0.007) were the predictive factors significantly associated with response to genicular RF. Conclusions: Clinical and technical factors associated with better treatment outcomes were ultimately targeting more nerves, performing prognostic block, no opioid use, and no depression. These results are expected to be considered when selecting patients for genicular RF.

• Clinics in Shoulder and Elbow
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• 제24권1호
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• pp.36-41
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• 2021

Chronic shoulder pain not relieved by either conservative or surgical management is referred to as chronic refractory shoulder pain. This is a retrospective case series where chronic refractory shoulder pain patients were treated either with peripheral nerve stimulation (PNS) or with pulsed radiofrequency (p-RF) therapy to the suprascapular nerve. Both patients receiving PNS reported 100% pain relief for the first month. At the 3- and 6-month follow-ups, one patient continued to experience 100% relief while the other reported 90% relief. One patient undergoing p-RF experienced about 90% pain relief at both 1- and 3-month intervals and 0% relief at the 6-month interval. The other patient with p-RF experienced 33% relief at 1-month and 0% relief thereafter. No patient reported any complications. The results of previous randomized controlled trials evaluating the efficacy of p-RF administered to the suprascapular nerve were mixed, and there is a lack of published studies on PNS effects. Neuromodulation of the suprascapular nerve can be effective for chronic refractory shoulder pain patients. Larger scale randomized controlled trials comparing PNS and p-RF are needed to better understand their respective therapeutic capacity.