Efficacy and Safety of Computed Tomography-Guided Pulsed Radiofrequency Modulation of Thoracic Dorsal Root Ganglion on Herpes Zoster Neuralgia

2018 ◽  
Vol 22 (1) ◽  
pp. 108-114 ◽  
Author(s):  
Yuanyuan Ding ◽  
Hongxi Li ◽  
Tao Hong ◽  
Rongjie Zhao ◽  
Peng Yao ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Herpes Zoster ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Pulsed Radiofrequency ◽  
Efficacy And Safety

scholarly journals Pulsed radiofrequency of dorsal root ganglion of upper thoracic segment for herpes zoster neuralgia

Medicine ◽  
2020 ◽  
Vol 99 (25) ◽  
pp. e20807
Author(s):  
Yong Fei ◽  
Jiajia Deng ◽  
Hui Lv ◽  
Ming Yao ◽  
Tingting Wang ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Thoracic Segment ◽  
Pulsed Radiofrequency ◽  
Upper Thoracic

scholarly journals First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

2017 ◽  
Vol 3 (20;3) ◽  
pp. E411-E418 ◽  
Author(s):  
EungDon Kim
Keyword(s):  
Herpes Zoster ◽  
Dorsal Root Ganglion ◽  
Postherpetic Neuralgia ◽  
Medical Records ◽  
Dorsal Root ◽  
Rating Scale ◽  
Small Sample ◽  
Intractable Pain ◽  
Clinical Effects ◽  
Pulsed Radiofrequency

Background: Latent varicella zoster virus reactivates mainly in sensory ganglia such as the dorsal root ganglion (DRG) or trigeminal ganglion. The DRG contains many receptor channels and is an important region for pain signal transduction. Sustained abnormal electrical activity to the spinal cord via the DRG in acute herpes zoster can result in neuropathic conditions such as postherpetic neuralgia (PHN). Although the efficacy of pulsed radiofrequency (PRF) application to the DRG in various pain conditions has been previously reported, the application of PRF to the DRG in patients with herpes zoster has not yet been studied. Objectives: The aim of the present study was to compare the clinical effects of PRF to the DRG in patients with herpes zoster to those of PRF to the DRG in patients with PHN. Study Design: Retrospective comparative study. Setting: University hospital pain center in Korea. Methods: The medical records of 58 patients who underwent PRF to the DRG due to zoster related pain (herpes zoster or PHN) were retrospectively analyzed. Patients were divided into 2 groups according to the timing of PRF after zoster onset: an early PRF group (within 90 days) and a PHN PRF group (more than 90 days). The efficacy of PRF was assessed by a numeric rating scale (NRS) and by recording patient medication doses before PRF and at one week, 4 weeks, 8 weeks, and 12 weeks after PRF. Results: Pain intensity was decreased after PRF in all participants. However, the degree of pain reduction was significantly higher in the early PRF group. Moreover, more patients discontinued their medication in the early PRF group, and the PRF success rate was also higher in the early PRF group. Limitations: The relatively small sample size from a single center, short duration of review of medical records, and the retrospective nature of the study. Conclusions: PRF to the DRG is a useful treatment for treatment-resistant cases of herpes zoster and PHN. Particularly in herpes zoster patients with intractable pain, application of PRF to the DRG should be considered for pain control and prevention of PHN. Key words: Pulsed radiofrequency, dorsal root ganglion, herpes zoster, postherpetic neuralgia

scholarly journals Efficacy and safety of pulsed radiofrequency modulation of thoracic dorsal root ganglion or intercostal nerve on postherpetic neuralgia in aged patients: a retrospective study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xuehua Huang ◽  
Yanfeng Ma ◽  
Weimin Wang ◽  
Yunxiu Guo ◽  
Bo Xu ◽  
...  
Keyword(s):  
Dorsal Root Ganglion ◽  
Elderly Patients ◽  
Postherpetic Neuralgia ◽  
Dorsal Root ◽  
Adverse Reactions ◽  
Intercostal Nerve ◽  
Pulsed Radiofrequency ◽  
Efficacy And Safety ◽  
Aged Patients ◽  
Sf 36

Abstract Background Postherpetic neuralgia (PHN) is common in elderly patients and can be alleviated by pulsed radiofrequency (PRF). However, PRF treatments display different efficacy on different nerves. The purpose of this study was to evaluate the efficacy and safety of ultrasound-guided PRF modulation on thoracic dorsal root ganglion (DRG) or intercostal nerve (ICN) for PHN in aged patients and to provide a theoretical basis for clinical treatment. Methods We classified aged patients into two groups, DRG group and ICN group, based on the needle tip position. Visual analogue scale (VAS) and concise health status questionnaire (Short-form 36 health/survey questionnaire, SF-36) were used to evaluate the pain intensity and the life quality of the patients before and 2, 4 and 12 weeks after the PRF treatments. We also recorded the adverse reactions during the treatments. Results After the PRF treatment, the scores of VAS and SF-36 (assessing general health perception, social function, emotional role, mental health, and pain) improved significantly in both groups (P < 0.05). The mean VAS score in the DRG group was significantly lower than that in the ICN group 2 weeks after treatment, and remained for 12 weeks. The SF-36 scores in the DRG group were significantly higher than those in the ICN group (P < 0.05). We found a similar incidence of adverse reactions between the two groups (P > 0.05). Conclusions PRF therapy is safe and effective for elderly patients with postherpetic neuralgia. However, PRF treatment in dorsal root ganglion is superior to that in intercostal nerve with improving VAS and SF-36 scores to a greater extent in older patients. Trial registration ChiCTR2100044176.

scholarly journals Pulsed Radiofrequency Application at Some Dorsal Root Ganglions Could Cause Drastic Neuromodulation throughout the Whole Body

2017 ◽  
pp. 223-229
Author(s):  
Young-Chang Arai
Keyword(s):  
Dorsal Root Ganglion ◽  
Analgesic Effect ◽  
Dorsal Root ◽  
Nervous Tissue ◽  
Case Series ◽  
Nerve Fibers ◽  
Whole Body ◽  
Intractable Pain ◽  
Pulsed Radiofrequency ◽  
Modified Technique

Background: The modified technique, pulsed radiofrequency (PRF) procedure, applied to nervous tissue has been providing anecdotal benefits for the management of chronic and intractable pain conditions. Although PRF has a neuromodulatory effect instead of thermally lesioning nervous tissue, the mechanism underlying the analgesic effect of PRF has not been fully clarified yet. Objectives: To see the changes of electricallyevoked responses of peripheral A-δ and A-β nerve fibers and the analgesic effect induced by PRF. Study Design: Case series. Setting: Inpatient. Methods: This study investigated how dorsal root ganglion (DRG) PRF influenced electricallyevoked responses of peripheral A-δ and A-β nerve fibers at the treated root ganglion dominating areas in five patients with intractable vertebral metastatic pain. Results: DRG PRF provided sound pain relief for patients with intractable vertebral metastatic pain. PRF application at DRGs had a different effect on electrically-evoked responses of peripheral A-δ and A-β nerve fibers at not only the treated root ganglion dominating areas but also the nontreated root ganglion dominating areas far from the treated root ganglion dominating areas in each patient. Limitation: This report is a case series. Conclusions: PRF application at some peripheral nerves could cause drastic neuromodulation throughout the whole body. Key words: Pulsed radiofrequency, dorsal root ganglion block, neuromodulation

scholarly journals Microglial BDNF, PI3K, and p-ERK in the Spinal Cord Are Suppressed by Pulsed Radiofrequency on Dorsal Root Ganglion to Ease SNI-Induced Neuropathic Pain in Rats

2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Xueru Xu ◽  
Shaoxiong Fu ◽  
Xiaomei Shi ◽  
Rongguo Liu
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Dorsal Root Ganglion ◽  
Nerve Injury ◽  
Calcium Binding ◽  
Dorsal Root ◽  
Intrathecal Injection ◽  
Pulsed Radiofrequency ◽  
Erk Phosphorylation ◽  
Extracellular Signal

Background. Pulsed radiofrequency (PRF) on the dorsal root ganglion (DRG) has been applied to alleviate neuropathic pain effectively, yet the mechanisms underlying pain reduction owing to this treatment are not clarified completely. The activated microglia, brain-derived neurotrophic factor (BDNF), phosphatidylinositol 3-kinase (PI3K), and phosphorylated extracellular signal-regulated kinase (p-ERK) in the spinal cord were demonstrated to be involved in developing neuropathic pain. Also, it has been just known that PRF on DRG inhibits the microglial activation in nerve injury rats. Here, we aim to investigate whether PRF treatment could regulate the levels of BDNF, PI3K, and p-ERK in the spinal cord of rats with spared nerve injury (SNI) via suppressing the spinal microglia activation to ease neuropathic pain. Methods. The rats with SNI were intrathecally treated with minocycline (specific microglia inhibitor) or same volume of dimethyl sulfoxide once daily, beginning from 1 h before nerve transection to 7 days. PRF was applied adjacent to the L4-L5 DRG of rats with SNI at 45 V for 6 min on the seventh postoperative day, whereas the free-PRF rats were treated without PRF. The withdrawal thresholds were studied, and the spinal levels of ionized calcium-binding adapter molecule 1 (Iba1), BDNF, PI3K, and p-ERK were calculated by western blot analysis, reverse transcription-polymerase chain reaction, and immunofluorescence. Results. The paw withdrawal mechanical threshold and paw withdrawal thermal latency decreased in the ipsilateral hind paws after SNI, and the spinal levels of Iba1, BDNF, PI3K, and p-ERK increased on day 21 after SNI compared with baseline (P<0.01). An intrathecal injection of minocycline led to the reversal of SNI-induced allodynia and increase in levels of Iba1, BDNF, PI3K, and p-ERK. Withdrawal thresholds recovered partially after a single PRF treatment for 14 days, and SNI-induced microglia hyperactivity, BDNF upregulation, and PI3K and ERK phosphorylation in the spinal cord reduced on D14 due to the PRF procedure. Conclusion. Microglial BDNF, PI3K, and p-ERK in the spinal cord are suppressed by the therapy of PRF on DRG to ease SNI-induced neuropathic pain in rats.

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