• The Korean Journal of Pain
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• 제11권2호
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• pp.302-306
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• 1998

The authors report the result achieved in the treatment of trigeminal neuralgia patient, especially V2 involved patient, using radiofrequency (RF) thermocoagulation of Gasserian ganglion. A 62-year old female patient had severe burning pain on right cheek usually initiating from upper molar teeth area for 10 years. She was treated with microvascular decompression operation 10 years ago. However, there was no pain relief by operation. She wanted non-surgical treatment. Therefore, we recommended RF thermocoagulation therapy. After 2 times of RF thermocoagulation, there was excellent pain relief without complications. And, for 6months follow-up, there were no pain, and no evidences of complication and recurrence.

• The Korean Journal of Pain
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• 제35권1호
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• pp.114-123
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• 2022

Background: Different views have been proposed on the radiofrequency treatment modes and parameters of radiofrequency thermocoagulation of the spinal dorsal root ganglion for the treatment of postherpetic neuralgia (PHN). It is urgent to identify a more effective therapy for patients with PHN. Methods: Patients who underwent radiofrequency thermocoagulation therapy for PHN were retrospectively reviewed and were divided into a radiofrequency thermocoagulation (CRF) and double neddles radiofrequency thermocoagulation (DCRF). The pain scores (numerical rating scale, NRS) were evaluated at the following time points: before the operation, 1 day, 3 months, 6 months, 1 year, and 2 years after operation. The incidence of complications and the degree of pain relief were evaluated. The in vitro ovalbumin experiment was used to indicate the effects of radiofrequency thermocoagulation. Results: Compared with the preoperative NRS scores, the postoperative NRS scores decreased significantly; the NRS scores of the DCRF group was lower than that of the CRF group at all time points from 6 months to 2 years following the operation. The total effective rate of the DCRF group was significantly higher than that of the CRF group at 2 years following the operation. The incidence of numbness in the DCRF group was higher than that noted in the CRF group. The ovalbumin experiments in vitro indicated that the effects of radiofrequency thermocoagulation were optimal when the distance between the two needles was 5 mm. Conclusions: DCRF with a 5 mm spacing exhibits a longer duration and higher effective rate in the treatment of PHN and is worth promoting.

• The Korean Journal of Pain
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• 제14권2호
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• pp.261-265
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• 2001

Radiofrequency thermocoagulation of the gasserian ganglion is a safe procedure that can be controlled well and provides satisfactory pain relief from trigeminal neuralgia with low risk. Here the authors report a case of radiofrequency thermocoagulation performed on a recurred trigeminal neuralgia patient, with particular attention to the V3 area. The patient was treated with microvascular decompression 7 years previous, which lead to untolerable side effects from carbamazepine medication. Following the paresthesia and masseter muscle contracture test at 50 Hz-0.06 volt and 2 Hz-0.5 volt respectively, RF lesionings were performed for 60 sec at $60^{\circ}C$ and 70 sec at $70^{\circ}C$. One week after the procedure, the pain was reduced with a mild hypoesthesia in the V2 area. After 6 months, the pain recurred. Therefore, we performed the same procedure again. After 8-months of follow-up, there has been no pain or complications.

• The Korean Journal of Pain
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• 제14권2호
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• pp.271-275
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• 2001

Buerger's disease is a nonatherosclerotic occlusive inflammatory disease of the small and medium arteries, and veins of the distal leg or arm. Percutaneous lumbar sympathectomy is used to lower extremity occlusive vascular disease as well as Buerger's disease. Lumbar sympathectomy improves blood flow and provides pain relief in the lower extremity. We report two cases of lumbar sympathectomy using radiofrequency thermocoagulation in patients with Buerger's disease. After no paresthesia and muscle contracture at 50 Hz, 1 volt and 2 Hz, 3 volts, respectively, radiofrequency lesioning was performed for 90 sec at $80^{\circ}C$. After the procedure, both patients showed skin temperature increases greater than $2^{\circ}C$ on the affected extremity. Both patients received relief from pain and symptoms without complications. We consider that lumbar sympathectomy using radiofrequency thermocoagulation is a safe and effective procedure that can relieve pain in patients with Buerger's disease.

• The Korean Journal of Pain
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• 제27권1호
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• pp.43-48
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• 2014

Background: This study tests the hypothesis that of bipolar radiofrequency thermocoagulation of the thoracic facet joint capsule may provide a safe and effect method of pain control from thoracic facet origin. Methods: Among patients suffering from localized mid back pain, nine patients with thoracic facet disease confirmed by magnetic resonance image and diagnostic thoracic facet block were enrolled. Bipolar radiofrequency ablation in the inferior aspect of the thoracic facet joint was done. Visual Analog Scale (VAS) was measured pre-intervention and 1 month post-intervention. Any complications and changes in amount of pain medication were recorded. Results: Significant 47.6% reduction in VAS was noted at 1 month. There were no serious complications. Conclusions: Intra-articular bipolar radiofrequency thermocoagulation of the thoracic facet joint may be a technically easier and valid method of treating mid back pain of thoracic facet origin.

• The Korean Journal of Pain
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• 제12권1호
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• pp.128-131
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• 1999

Stellate ganglion block is a well established method for the management of certain pain syndromes (e.g., chronic regional pain syndrome, facial pain) in the cervicothoracic region and upper extremity. The stellate ganglion resides between the C7 transverse process and the head of the first rib. Anesthetic injections for the stellate ganglion block are typically made at the level of the transverse process of either the C6 or C7 vertebrae to avoid the pleura, vessels, and nerve roots. Method of positioning the needle tip directly at the ganglion has been described, but are problematic because of the risk of injury to or injection into adjacent structures. It is necessary to know the exact anatomic position of the stellate ganglion when permanent blockade is required by means of radiofrequency thermocoagulation. Whereas fluroscopy shows only bony feature, computerized tomography also images nerves, vessels, and lung, allowing accruate needle placement. We report a case of the percutaneous radiofrequency thermocoagulation of the stellate ganglion after computerized tomography-guided localization.

• The Korean Journal of Pain
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• 제12권1호
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• pp.162-167
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• 1999

We have observed discitis developed after Intradiscal radiofrequency thermocoagulation in a patient with chronic discogenic low back pain. Recently, it is becoming more common that pain-managers perform disc-manipulation or, a nerve block after penetrating a disc, so postprocedural infection of disc can be a problem. To prevent discitis, very carefull attention must be given to ensure aseptic conditions during this procedure. However, if it occurs, it needs to be treated properly. In this case, a good result was obtained by treatment with absolute bed rest, pain management, and antibiotics.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.827-836
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• 2021

Objective : Trigeminal neuralgia is one of the most common causes of facial pain. Our aim is to investigate the efficacy and borders of percutaneous radiofrequency thermocoagulation in the treatment of trigeminal neuralgia. Methods : Between May 2007 and April 2017, 156 patients with trigeminal neuralgia were treated with radiofrequency thermocoagulation. These 156 patients underwent 209 procedures. In our study, we investigated the early and late results of percutaneous radiofrequency thermocoagulation under guiding fluoroscopic imaging in the treatment of trigeminal neuralgia. Barrow Neurological Institute (BNI) pain scale was used for grading the early results. In addition, Kaplan-Meier survival analysis was used to assess long-term outcomes. Of the 156 patients who underwent radiofrequency thermocoagulation for trigeminal neuralgia, 45 had additional disease. Patients with this condition were evaluated with their comorbidities. Early and late results were compared with those without comorbidity. Results : In 193 of 209 interventions BNI pain scale I to III results were obtained. Out of the 193 successful operation 136 patients (65.07%) were discharged as BNI I, 14 (6.70%) as BNI II, 43 (20.58%) as BNI III. Sixteen patients (7.65%) remained uncontrolled (BNI IV and V). While the treatment results of trigeminal neuralgia patients with comorbidity seem more successful in the early period, this difference was not observed in follow-up examinations. Conclusion : Finally, we concluded that percutaneous radiofrequency thermocoagulation of the Gasserian ganglion is a safe and effective method in the treatment of trigeminal neuralgia. However, over time, the effectiveness of the treatment decreases. Neverthless, the reapprability of this intervention gives it a distinct advantage.

• The Korean Journal of Pain
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• 제12권2호
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• pp.227-230
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• 1999

The sphenopalatine ganglion lies behind the middle nasal concha in the sphenopalatine foramen which connects the fossa to the nasal cavity. It has sympathetic and parasympathetic fibers as well as sensory fibers which innervate the nasal cavity, palate and nasopharynx. Current indications for blockade of the sphenopalatine ganglion include the management of migraine, cluster headache and a variety of facial neuralgias. Blockage of this ganglion can be attempted when more conservative treatments have failed. If the pain relief gained through the procedure is of short duration and the blockage needs to be repeated frequently, then radiofrequency thermocoagulation should be considered. Since the sphenopalatine ganglion lies close to the maxillary nerve, neurolytics can cause facial dysesthesia, radiofrequency thermocoagulation is the preferred method for ganglionotomy. Radiofrequency thermocoagulation of the sphenopalatine ganglion was done for 3 patients who suffered from postherpetic neuralgia, cluster headache, atypical facial pain respectively. Good results were obtained with the exception of the patient suffering from atypical facial pain. Although we were concerned about complications such as epistaxis, none were encountered. However it should be noted that caution must be exercised when repeatedly redirecting the cannula in the sphenopalatine fossa as serious bleeding and pronounced facial swelling may result.

• The Korean Journal of Pain
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• 제11권2호
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• pp.299-301
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• 1998

Stellate ganglion block is frequently effective on the pain of head and upper extremities. However, if the degree and duration of pain relief does not increase with repeated blocks, we may consider the neurolytic procedure on the stellate ganglion. A patient sufferring from the pain in the region of ophthalmic branch of left trigeminal nerve and left eyeball region had been treated with stellate ganglion block. In spite of repeated blocks, the degree and duration of pain relief did not increase. We performed the radiofrequency thermocoagulation of stellate ganglion at the operation room under fluoroscopy. Patient got pain relief immediately after the procedure without any remarkable complication except a mild ptosis, which was shown before the procedure. We may give priority to radiofrequency thermocoagulation for stellate ganglion neurolysis due to its simplicity and safty.