• The Korean Journal of Pain
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• v.19 no.2
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• pp.282-284
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• 2006

Percutaneous radiofrequency thermocoagulation has been applied in patients with various forms of chronic pain, such as facet joint pain, cancer pain and trigeminal neuralgia. A major portion of the hip joint is innervated by the articular branches of the femoral and obturator nerves. Radiofrequency thermocoagulation of the articular branches of the obturator and femoral nerves can be a good alternative treatment for patients with hip joint pain, especially in those where surgery is not applicable. A patient suffering hip joint pain due to metastatic cancer underwent multiple radiofrequency lesioning of the femoral and obturator nerves at $80^{\circ}C$ for 120 seconds, using a Racz-Finch Kit. The patient experienced about a 50% reduction in the pain, without any numbness or other side effects.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.116-122
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• 2007

Background: Lumbar zygapophysial joints are a common source of chronic lower back pain and radiofrequency thermocoagulation (RF) of the medial branches (MB) has been shown to be effective at providing substantial pain relief for chronic low back pain. Therefore, we carried out this study to determine the short term outcomes and prognostic factors of RF on the MB of patients with lumbar facet syndrome. Methods: We performed RF in fourteen patients who showed greater than 80% pain relief up to three times after a diagnostic MB block was conducted using 0.3 ml of 0.5% bupivacaine. Using 10 cm curved electrodes with 10-mm active tip, a 60 second, $80^{\circ}C$ lesion was made after electrical stimulation at 50 Hz for sensory and 2 Hz for motor nerve testing. The degree of pain relief was then assessed after 2 weeks, and again after 3 months using a visual analog scale (VAS) and a four point Likert scale. The outcome was regarded as 'success' if at least a 50% reduction in the VAS was observed. Possible prognostic factors between the two groups were also evaluated Results: The success rate was 71.4% (10/14) after three months of follow-up. However, there were transient complications, such as neuritis like syndrome, in 4 patients. In addition, short symptom duration and low minimal voltage (< 0.4 V) for sensory stimulation were shown to be the relevant prognostic factors for a successful outcome. Conclusions: RF may be an alternative to repeated MB block or intraarticular injection for palliation of lumbar facet syndrome. For better outcomes, early diagnosis and strict patient selection should be coupled with efforts to avoid anatomically incorrect RF.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.196-201
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• 2000

Background: Currently, minimally invasive operations are preferred to open surgery whenever possible. Lumbar sympathectomy using RF (radiofrequency) thermocoagulation is both safe and minimally invasive. The problem with the technique is that it cannot be performed successfully in a significant number of cases. If the temperature change in the sole is monitored immediately after the procedure then it can be determined if the procedure needs to be repeated. Methods: A curved tip cannula, 150 mm long with a 10 mm active tip, was used for RF lumbar sympathectomy. The temperature of the soles of both the foot on the affected side and the foot on the control side was monitored immediately before the procedure, immediately after making the L2 lesion, immediately after making the L3 lesion and at 5, 10, and 15 minutes after the procedure. Results: No statistically significant difference was observed in the temperature of the two soles before making the lesions. In the 24 of the 27 patients, there were prominent differences in temperature between the two soles at 10 minutes after the procedures. 11 of the 24 patients showed a significant temperature change after the first trial. But the remaining 13 required a second lesion on L2 and L3. Conclusions: We judged the success of the operation in the operating room by monitoring the temperature difference in the soles of the feet. When no increase in the temperature difference is observed, we can move the electrode and make another lesion. With this procedure, we can drastically increase the success rate of the procedure.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.263-266
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• 2005

The ganglion impar is a solitary retroperitoneal structure at the caudal end of the paravertebral sympathetic chain. Block of this ganglion has been advocated as a means of managing intractable perineal pain. In 1990, Plancarte et al performed a neurolytic block of the ganglion impar using 4-6 ml of 10% phenol through the intergluteal skin over the anococcygeal ligament. However, technical difficulties are encountered with the placement of the needle while performing this technique, with complications from the injection of phenol also being a possibility. In 1995, a modified approach for blocking the ganglion impar through the sacrococcygeal ligament was introduced by Wemm and Saberski. We used a radiofrequency (RF) lesion generator to create a controlled and localized lesion with a lower incidence of neural damages compared to chemical neurolysis. RF thermocoagulation of the ganglion impar through the sacrococcygeal ligament was performed on a 70-year-old male patient with constant anal pain using a curved TEW electrode. The patient has been relieved of his pain, without serious complication. Therefore, this technique may be an easier and safer approach, which is associated with fewer chances of complications.

• The Korean Journal of Pain
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• v.36 no.4
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• pp.465-472
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• 2023

Background: Percutaneous radiofrequency thermocoagulation (RFTC) has been widely utilized in the management of trigeminal neuralgia. Despite using image guidance, accurate needle positioning into the target area still remains a critical element for achieving a successful outcome. This study was performed to precisely clarify the anatomical information required to ensure that the electrode tip is placed on the sensory component of the mandibular nerve (MN) at the foramen ovale (FO) level. Methods: The study used 50 hemi-half heads from 26 South Korean adult cadavers. Results: The cross-sectioned anterior and posterior divisions of the MN at the FO level could be distinguished based on an irregular boundary and color difference. The anterior division was clearly brighter than the posterior one. The anterior division of the MN at the FO level was located at the whole anterior (38.0%), anteromedial (6.0%), anterior center (8.0%), and anterolateral (22.0%) parts. The posterior division was often located at the whole posterior or posterolateral parts of the MN at the FO level. The anterior divisions covered the whole MN except for the medial half of the posterolateral part in the overwrapped images of the cross-sectional areas of the MN at the FO level. The cross-sectional areas of the anterior divisions were similar in males and females, whereas those of the posterior divisions were significantly larger in males (P = 0.004). Conclusions: The obtained anatomical information is expected to help physicians reduce unwanted side effects after percutaneous RFTC within the FO for the MN.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.74-77
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• 1995

Upper thoracic sympathectomy is valuable for patients with vascular occlusive disease and other painful upper extremity diseases. We performed 10 upper thoracic sympahthectomies by percutaneous radiofrequency destruction in painful disorder of upper extremity. Patients were supine and the needle was inserted paratracheally under C-arm fluoroscope. The second and third thoracic sympathetic gangla were destructed by radiofrequency lesion generator. Each lesion was made with a tip temperature of $90^{\circ}C$, 90 seconds. Good to excellent results were achieved in all patients without any adverse effect. Seven patients revealed complete sympatholytic effect and other three patients were showen signs of partial sympathetic block. Two patients were persisted sympatholytic effect for 18month in and other 5 patients were persisted sympatholytic effect at present (follow up period: mean 5.8 mon). Percutaneous radiofrequency upper thoracic sympathectomy with anterior paratracheal approach is an effective and a safe method.

• The Korean Journal of Pain
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• v.18 no.1
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• pp.92-95
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• 2005

Primary hyperhidrosis, a disorder of unknown etiology, is characterized by excessive uncontrollable sweating, most often of the palm surface of the hands, armpits, groin and feet. To decrease the symptoms of hyperhidrosis, drug therapy, iontophoresis, excision of axillary sweat glands and thoracoscopic sympathectomy have been attempted. A lumbar sympathectomy is one of the available choices for the treatment hyperhidrosis of the lower extremities. A 28-year old female patient presented with excessive sweating of her hands and feet. For the treatment of her foot hyperhidrosis, a bipolar radiofrequency ablation system was used to ablate the lumbar sympathetic ganglion, with a successful result. This modality will receive greater attention as an available alternative to lumbar sympathetic neurolysis.

• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.622-632
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• 2022

Microvascular decompression is the gold standard for the treatment of trigeminal neuralgia (TN). However, percutaneous techniques still play a role in treating patients with TN and offer several important advantages and efficiency in obtaining immediate pain relief, which is also durable in a less invasive and safe manner. Patients' preference for a less invasive method can influence the procedure they will undergo. Neurovascular conflict is not always a prerequisite for patients with TN. In addition, recurrence and failure of the previous procedure can influence the decision to follow the treatment. Therefore, indications for percutaneous procedures for TN persist when patients experience idiopathic and episodic sharp shooting pain. In this review, we provide an overview of percutaneous procedures for TN and its outcome and complication.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.200-205
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• 1996

Radiofrequency thermocoagulation(RF) techniques are safe and effective methods as compared to neurodestructive procedure. Other advantages are: ability to perform RF lesions under local or sedative anesthesia, rapid recovery period, low incidence of morbidity and mortality, ability to repeat RF lesions, and leaves no significant scarring. We performed C2 ganglionotomy by RF lesion generator on a patient, suffering post-traumatic occipital neuralgia, as the patient did not respond to conservative therapies such as: trigger point injection, TENS, cryotherapy and stretch, occipital nerve block, C2 ganglion block. Prognostic nerve block was performed usng local anesthetics. Excellent effect was conformed before C2 ganglionotomy. This procedure was performed under fluoroscopy. Type RCK-2A Rosomoff Cordotomy kit was used to stabilize the head and neck. Postoperatively, the patient was free of occipital pain and head motions no longer triggered pain. To date, the patient remains symptom free except for some cervical discomfort.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.383-385
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• 1995

Postpuncture headache is the most common complication of epidural block, others include abscission of the tip of catheter, epidural abscess and subarachnoid infection, etc. A 69-year-old female patient visited the Neuro-Pain Clinic of Seran General Hospital for treatment of lower back pain and both sciatica. She received continuous epidural block, psoas compartment block, lumbar facet joint block and lumbar facet thermocoagulation. During the epidural block procedure the dura was accidently punctured and auto-logous blood patch was performed. Three days later, she manifested fever, nausea, vomiting, mild neck stiffness and mental deterioration. Meningitis was suspected as the cause of these signs. The CSF study reported: protein 400 mg/dl, sugar 14 mg/dl, WBC $468/mm^3$. She was recovered from the meningitis after adequate antibiotic therapy.