The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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A New More Reliable Indicator for Confirmation of the Medial Branch in Radiofrequency Neurotomy -Case report-

고주파열응고술을 이용한 척수신경 후내측지 신경절제술에서 후내측지를 확인하는 새로운 기준 -증례 보고-

  • Shin, Keun-Man (Department of Anesthesiology, College of Medicine, Hallym University) ;
  • Choi, Sang-Eun (Department of Anesthesiology, College of Medicine, Hallym University) ;
  • Yun, Seon-Hye (Department of Anesthesiology, College of Medicine, Hallym University) ;
  • Lim, So-Young (Department of Anesthesiology, College of Medicine, Hallym University) ;
  • Jung, Bae-Hee (Department of Anesthesiology, College of Medicine, Hallym University) ;
  • Lee, Kee-Heon (Department of Anesthesiology, College of Medicine, Hallym University) ;
  • Hong, Soon-Yong (Department of Anesthesiology, College of Medicine, Hallym University) ;
  • Choi, Young-Ryong (Department of Anesthesiology, College of Medicine, Hallym University)
  • 신근만 (한림대학교 의과대학 마취과학교실) ;
  • 최상은 (한림대학교 의과대학 마취과학교실) ;
  • 윤선혜 (한림대학교 의과대학 마취과학교실) ;
  • 임소영 (한림대학교 의과대학 마취과학교실) ;
  • 정배희 (한림대학교 의과대학 마취과학교실) ;
  • 이기헌 (한림대학교 의과대학 마취과학교실) ;
  • 홍순용 (한림대학교 의과대학 마취과학교실) ;
  • 최영룡 (한림대학교 의과대학 마취과학교실)
  • Published : 2000.11.30
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Abstract

Radiofrequency medial branch neurotomy is an effective way of controlling pain in the posterior compartment of the spine such as the facet joint, and the interspinous ligament. However, it is difficult to determine the exact location of the medial branch. Up until now we have relied on sensory response provoked by 50 Hz stimulation. The responses elicited using this method are quite subjective and can originate from sources other than the medial branch such as the periosteum, the intermediate or lateral branch. We need a confirmed indicator to locate the medial branch reliably. We applied 2 Hz stimulation under 0.4 volts to locate the medial branch and elicited a motor response. Twitching of multifidus and muscles around the SI joint was observed. The observation of these muscles provides a much more reliable method for confirmation of the medial branch. We have treated 45 chronic nonspecific low back pain patients using radiofrequency medial branch neurotomy with this method of confirming the medial branch.

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