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Korean J Anesthesiol. 2004 Dec;47(6):840-845. Korean. Original Article.
Shim JC , Jung SY , Kim DW .
Department of Anesthesiology and Pain Medicine, School of Medicine, Hanyang University, Seoul, Korea.

BACKGROUND: Whiplash associated disorder (WAD) is one of the most common causes of neck pain and cervicogenic headache. One proposed method of treating neck pain and cervicogenic headache is the ablation of cervical medial branch with pulsed radiofrequency thermocoagulation (PRFT). This study was a retrospective evaluation of the effect of the PRFT in patients with WAD who did not show any responses to the various conservative treatments. METHODS: Short term outcome was ascertained among 7 patients with the PRFT of cervical medial branches, who had shown positive response to the diagnostic block. During the PRFT under the guidance of C-arm image, impedance and sensory electrical nerve stimulation threshold were assessed. After obtaining appropriate stimulation, PRFT was performed to the cervical medial branches at 42degreesC for 120 seconds. Three out of 7 patients were treated unilaterally. For the assessment of short term outcome, the 4 point Likert scale was adopted. The result was regarded as favorable if pain reduction were more than 50% on the scale. RESULTS: Mean duration of pain was 415.3 +/- 233.4 days. Average follow-up interval was 76.4 +/- 10.1 days. Two patients did not respond favorably to the PRFT. In 5 patients who showed favorable response to the PRFT, the effect lasted on average 76.4 +/- 10.1 days. CONCLUSIONS: The PRFT of cervical medial branches might be an effective treatment modality in patients with WAD and who did not show any responses to the conservative managements.

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