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Pulsed Radiofrequency of the Dorsal Root Ganglia is Superior to Pharmacotherapy or Pulsed Radiofrequency of the Intercostal Nerves in the Treatment of Chronic Postsurgical Thoracic Pain
Steven P. Cohen, MD, Anthony Sireci, BA, Christopher L. Wu, MD, Thomas M. Larkin, MD,Kayode A. Williams, MD, and Robert W. Hurley, MD, PhD
Pain Physician. 2006;9:227-236
From: Department Of Anesthesiology & Critical Care Medicine, Pain Management Division, Johns Hopkins School Of Medicine, Baltimore, Md; and
Department of Surgery, Walter Reed Army Medical Center, Washington, DC
Background: Chronic postsurgical thoracic pain (CPTP) represents a major therapeutic challenge characterized by an absence of clinical studies to guide treatment. Recently, the implementation of pulsed radiofrequency (RF) has generated intense interest in the medical community as a safe and potentially effective treatment for neuropathic pain. To date, there are no studies comparing pulsed RF to more conventional therapeutic modalities for any pain condition.
Objectives: To compare treatment outcomes between pharmacotherapy, pulsed RF of the intercostal nerves (ICN) and pulsed RF of the dorsal root ganglia (DRG) in CPTP.
Methods: Retrospective data analysis involving 49 patients.
Results: At 6-week follow-up, 61.5% of the pulsed RF DRG group reported ≥50% pain relief vs. 27.3% in the medical management (MM) group and 21.4% in the ICN group (P=0.12). At 3-month follow-up, 53.8% in the DRG group continued to report ≥ 50% pain relief vs. 19.9% in the MM and 6.7% in the ICN groups, respectively (P=0.02). Among the pulsed RF patients who did report a successful outcome, the mean duration of pain relief was 2.87 months in the ICN group and 4.74 months in the DRG group (P=0.01).
Conclusions: Pulsed RF of the DRG was a superior treatment to pharmacotherapy and pulsed RF of the ICN in patients with CPTP. Prospective studies are needed to confirm these results and identify the best candidates for this treatment.
Steven P. Cohen, MD, Anthony Sireci, BA, Christopher L. Wu, MD, Thomas M. Larkin, MD,Kayode A. Williams, MD, and Robert W. Hurley, MD, PhD
Pain Physician. 2006;9:227-236
From: Department Of Anesthesiology & Critical Care Medicine, Pain Management Division, Johns Hopkins School Of Medicine, Baltimore, Md; and
Department of Surgery, Walter Reed Army Medical Center, Washington, DC
Background: Chronic postsurgical thoracic pain (CPTP) represents a major therapeutic challenge characterized by an absence of clinical studies to guide treatment. Recently, the implementation of pulsed radiofrequency (RF) has generated intense interest in the medical community as a safe and potentially effective treatment for neuropathic pain. To date, there are no studies comparing pulsed RF to more conventional therapeutic modalities for any pain condition.
Objectives: To compare treatment outcomes between pharmacotherapy, pulsed RF of the intercostal nerves (ICN) and pulsed RF of the dorsal root ganglia (DRG) in CPTP.
Methods: Retrospective data analysis involving 49 patients.
Results: At 6-week follow-up, 61.5% of the pulsed RF DRG group reported ≥50% pain relief vs. 27.3% in the medical management (MM) group and 21.4% in the ICN group (P=0.12). At 3-month follow-up, 53.8% in the DRG group continued to report ≥ 50% pain relief vs. 19.9% in the MM and 6.7% in the ICN groups, respectively (P=0.02). Among the pulsed RF patients who did report a successful outcome, the mean duration of pain relief was 2.87 months in the ICN group and 4.74 months in the DRG group (P=0.01).
Conclusions: Pulsed RF of the DRG was a superior treatment to pharmacotherapy and pulsed RF of the ICN in patients with CPTP. Prospective studies are needed to confirm these results and identify the best candidates for this treatment.
