Korean J Pain.  2022 Jan;35(1):114-123. 10.3344/kjp.2022.35.1.114.

Evaluation of the efficacy of unipolar and bipolar spinal dorsal root ganglion radiofrequency thermocoagulation in the treatment of postherpetic neuralgia

• Zhu J
• Luo G
• He Q
• Yao M

• KMID: 2524655
• DOI: http://doi.org/10.3344/kjp.2022.35.1.114

Abstract

Background
Different views have been proposed on the radiofrequency treatment modes and parameters of radiofrequency thermocoagulation of the spinal dorsal root ganglion for the treatment of postherpetic neuralgia (PHN). It is urgent to identify a more effective therapy for patients with PHN.
Methods
Patients who underwent radiofrequency thermocoagulation therapy for PHN were retrospectively reviewed and were divided into a radiofrequency thermocoagulation (CRF) and double neddles radiofrequency thermocoagulation (DCRF). The pain scores (numerical rating scale, NRS) were evaluated at the following time points: before the operation, 1 day, 3 months, 6 months, 1 year, and 2 years after operation. The incidence of complications and the degree of pain relief were evaluated. The in vitro ovalbumin experiment was used to indicate the effects of radiofrequency thermocoagulation.
Results
Compared with the preoperative NRS scores, the postoperative NRS scores decreased significantly; the NRS scores of the DCRF group was lower than that of the CRF group at all time points from 6 months to 2 years following the operation. The total effective rate of the DCRF group was significantly higher than that of the CRF group at 2 years following the operation. The incidence of numbness in the DCRF group was higher than that noted in the CRF group. The ovalbumin experiments in vitro indicated that the effects of radiofrequency thermocoagulation were optimal when the distance between the two needles was 5 mm.
Conclusions
DCRF with a 5 mm spacing exhibits a longer duration and higher effective rate in the treatment of PHN and is worth promoting.

Keyword

Chronic Pain; Electrocoagulation; Ganglia; Spinal; Herpes Zoster; In Vitro Techniques; Incidence; Needles; Neuralgia; Postherpetic; Ovalbumin; Pain Management; Radiofrequency Therapy; Spine

Figure

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  Fig. 1 Surgical procedure of radiofrequency thermocoagulation. (A) Place positioning mark. (B) Design the puncture route. (C) Puncture to predetermined position.

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  Fig. 2 Surgical procedure of double neddles radiofrequency thermocoagulation. (A) Place positioning mark. (B, C) Design the puncture route. (D) Puncture to predetermined position.

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  Fig. 3 The active tip of the needle was wrapped by ovalbumin in CRF group (A) and DCRF (B). CRF: radiofrequency thermocoagulation, DCRF: double neddles radiofrequency thermocoagulation.

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  Fig. 4 The length (A), width (B), height (C) and weight (D) of coagulum in each group. CRF: radiofrequency thermocoagulation.

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