Abstract
Radio frequency thermal coagulation has been applied to treat various types of neuralgia. The procedure is applied to the type of pain for which nerve block is only temporarily effective and there are no other analgesic modalities available. The basic approach taken is same as that for trigger point and nerve root blocks: specifically, the electrode needle is inserted after administering a light local anesthesia. It may be conducted under fluoroscopy or guided by CT. The tip of the needle may be located by using reproducible referred pain or radiographic findings as a reference. It is made certain that the electrode needle does not affect the motor nerves and is located near the sensory nerve. The coagulation temperature is set between 60 and 90°C and the coagulation time, between 90 and 120 seconds. The effect of the procedure is judged based on analgesia 2 to 3 days after the treatment. A satisfactory analgesic effect is often noted immediately after coagulation. If it is applied to suitable pain conditions, the procedure may be an effective analgesic method that can be conducted at a pain clinic. It is indicated for refractory RSD, trigeminal neuralgia, spondylosis deformans with marked radicular symptoms, compression fractures, and postherpetic neuralgia. Adverse effects include numbness, pain at the site of coagulation, and slight motor dysfunction. Clinical cases are presented together with some explanation.
