• The Korean Journal of Pain
• /
• v.4 no.2
• /
• pp.196-199
• /
• 1991

Efforts from many different approaches have been made to manage malignant sacral pain that commonly occurs in cancers from pelvic origin. Radiofrequency thermocoagulation provides a safe method of achieving long standing relief of intractable pain without some of the objectable side effects associated with other forms of chemical or surgical therapy. Radiofrequency sacral rhizotomy is a new method for the relief of the sacrococcygeal pain. We report a case in which we managed a patient with malignant sacrococcygeal pain with radiofrequency thermocoagulation.

• The Korean Journal of Pain
• /
• v.14 no.2
• /
• pp.239-244
• /
• 2001

Stellate ganglion block (SGB) is a frequently used sympathetic block utilized to diagnose or treat various painful conditions of the cervical regions and the upper extremities. Additionally, RadioFrequency (RF) lesions of the stellate ganglion can be useful in managing sympathetically-maintained pain. Two patients were suffering from pain in the face, neck and the upper extremities were treated with stellate ganglion block. In spite of repeated blocks, the degree and duration of pain did not decrease. However, after performing radiofrequency thermocoagulation of the stellate ganglion under fluroscopy, followed by thermography on the process of treatment with RF stellate ganglion neurolysis, the patients' pain levels were alleviated after the RF lesions of stellate ganglion and the procedure also increased the temperature at the upper extremity on thermogarphy. Additionally, the patients did not complain of any remarkable complications following this procedure.

• The Korean Journal of Pain
• /
• v.10 no.1
• /
• pp.86-88
• /
• 1997

Regional sympathetic blockade is the most effective treatment for reflex sympathetic dystrophy (RSD). Radiofrequency thermocoagulation provides longer duration of pain relief than local anesthetics and less complication than chemical neurolytic agents for lumbar sympathectomy. Spinal cord stimulation (SCS) is thought to be an effective modality yieding good results in treating intractable neuropathic pain. Therefore RSD might be a good indication for SCS. We treated a patient with RSD who responded well to lumbar sympathetic blockade (LSB) with radiofrequency thermocoagulation and SCS. The patient had a left ankle sprain requiring a case for the lower leg for 2 weeks. The patient suffered increasing pain and swelling on the lower part of that leg. We thought to block the lumbar sympathetic chain utillzing radiofrequency thermocoagulation 2 days after LSB with local anesthetics. The results provided accepatable pain relief (VAS $8{\rightarrow}15$) but the patient still could not walk due to remaining pain which was further aggravated by walking. After SCS, pain relief improved (VAS $5{\rightarrow}13$) and patient could walk without assistance.

• The Korean Journal of Pain
• /
• v.18 no.2
• /
• pp.240-245
• /
• 2005

Herein is described the successful treatment of complex regional pain syndrome type II with the combination treatment of spinal cord stimulation and radiofrequency thermocoagulation of the lumbar sympathetic ganglion. A 62 years old male patient, suffering from CRPS type II in his left lower extremity, visited our pain clinic. Medication and nerve blockade produced only slight improvement in his symptoms and signs. Therefore, a linear type spinal cord simulator was inserted into the thoracic epidural space, using a non-surgical percutaneous approach, with the cephalad lead located at the T11 level. Two months later, the repositioning of the electrode to the T12 level for more effective pain control, with radiofrequency thermocoagulation of lumbar sympathetic ganglion also performed at the left L2 and 3 levels for the control of trophic change. These resulted in significant pain relief and decreased trophic change, with no complications, after which the patient was able to resume a normal life.

• The Korean Journal of Pain
• /
• v.10 no.1
• /
• pp.82-85
• /
• 1997

Destruction of the gasserian ganglion can be carried out by creating a radiofrequency lesion under biplanar fluoroscopic guidance. This procedure is reserved for patients who have failed various interventions for intractable trigeminal neuralgia including retro-gasserian injection of glycerol and whose physical status otherwise precludes more invasive neuro-surgical treatments such as microvascular decompression. Radiofrequency thermocoagulation of the gasserian ganglion provides a safe method of achieving long-standing relief from trigeminal neuralgia with low risk. This technique is currently emerging worldwide as the surgical treatment of choice for trigeminal neuralgia. Recently we performed a successful radiofrequency gasserian ganglionotomy, without any complication, under fluoroscopic guidance. The procedure was successful and complete pain relief was achieved for a patient who already had treatments of various interventions including microvascular decompression but never experienced pain relief.

• The Korean Journal of Pain
• /
• v.9 no.1
• /
• pp.183-186
• /
• 1996

When medical therapy fail to relieve pain at tolerable level for patients confirmed with trigeminal neuralgia, presence of mass lesion excluded, surgery is indicated. Innumerable surgical strategies have been attempted for the treatment of trigeminal neuralgia but only four have proven appropriate: (1)stereotactic radiofrequency gasserian ganglionotomy, (2) percutaneous glycerol gangliolysis, (3) percutaneous microcompression, (4) microvascular decompression. Radiofrequency thermocoagulation of the gasserian ganglion stems from the efforts of Sweet. This technique is the surgical treatment of choice around the world for surgical treatment for trigeminal neuralgia. Since 1986, over 14,000 cases have been reported utilizing this technique. To improve the treatment method further, an electrode with a flexible curved tip has been developed for easier and more precise electrode placement and lesion production during the thermocoagulation of gasserian ganglion. This operation was performed recently on three patients at Hallym University Hospital. using a curved tip electrode. Complete relief of pain was achieved for all patient. However, some complications were noted.

• Journal of Korean Neurosurgical Society
• /
• v.59 no.4
• /
• pp.410-413
• /
• 2016

Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method.

• Journal of Korean Neurosurgical Society
• /
• v.50 no.5
• /
• pp.446-452
• /
• 2011

Objective : We retrospectively investigated the long-term results of percutaneous radiofrequency thermocoagulation (RFT) using fluoroscopic image-guidance for treatment of trigeminal neuralgia. Methods : A total of 38 patients diagnosed and treated with RFT as an idiopathic trigeminal neuralgia were investigated. To minimize the risks related to conventional technique based on cutaneous landmarks, and to eliminate the need to frequent reposition of cannula, we adopted a technique of image-guided fluoroscopic cannulation of the foramen ovale. To minimize sensory complication following thermal lesion, our target response was a generation of a lesion with mild to moderate hypalgesia rather than dense hypalgesia. Results : The immediate pain-relief was achieved in all patients underwent RFT. With mean duration of follow-up of 38.2 months (range,12-72), 11 (28.9%) experienced recurrence of pain. The mean timing of recurrence was 26.1 months (range,12-46). A 42.7% recurrence rate was estimated by Kaplan-Meier analysis for the 38 patients at 46 months; 20.2% within 2 years, 29.1% within 3 years. In the long-term, 27 patients (71%) and 6 patients (15.8%) showed Barrow Neurological Institute (BNI) score I and BNI score II responses. Three (7.9%) patients was assessed as BNI score III, 2 patients (5.3%) showed BNI score IV response. As a complication, troublesome dysesthesia occurred in 3 of 38 patients (7.9%), however, there was no permanent cranial nerve palsy or morbidity. Conclusion : These results indicates that RFT under fluoroscopic image-guided cannulation of foramen ovale is a safe, effective, and reliable means of treating trigeminal neuralgia.

• The Korean Journal of Pain
• /
• v.19 no.2
• /
• pp.228-232
• /
• 2006

Complex regional pain syndrome (CRPS) type 1 is characterized by the presence of pain, which is severe, diffuse and associated with allodynia, and is also associated with autonomic and trophic changes. The sensitization phenomena of CRPS also cause allodynia and itching, as well as pain. These symptoms are the issues associated with the treatment of CRPS. Under normal conditions, an antagonistic interaction exists between the pain and itching, but the patterns of peripheral and central sensitization phenomena for the pain and itching are very similar. The chronic pain and chronic itch have similar characteristics in their developmental and therapeutical principles. Herein, our experience of 2 cases of CRPS, which showed improvement of these facial symptoms after sphenopalatine ganglion radiofrequency thermocoagulation, but were not controlled by spinal cord stimulation or other conservative treatments, is reported.

• The Korean Journal of Pain
• /
• v.9 no.2
• /
• pp.415-418
• /
• 1996

The first reported the neural blockade of ganglion impar for pain control of perineal pain in 1990 by Plancarte and his fellows. they used 6ml of 10 percent phenol. but the point of issues, same as other neurolytics, are that it is impossible to check and control its spreading, so it might be possible to destruct the coccygeal plexus and sacral nerve, and also it has only short action time. Because of these problems, it could be very dangerous to attempt this procedure especially not for relieving the pain on cancer terminal patient, but for the sympathectomy of ganglion impar on the other purpose. We used the RF generator which had the control ability to point out the destructive lesion accurately. inserted We made the small burr hole on the sacrum near the sacrococcygeal junction directly, through the hole, and performed thermocoagulation to the ganglion impar.