A prospective study of radiofrequency in the treatment of lumbar facet joint pain in the elderly / 中华老年医学杂志

Objective:To examine the effect of minimally invasive radiofrequency(RF)thermocoagulation of the posterior medial branch of the spinal nerves on lumbar facet joint(LFJ)pain in the elderly.Methods:Patients over 60 years old with LFJ pain were randomly divided into an RF group and a control group.The primary outcome measures were the numerical rating scale(NRS)for pain assessment and the proportion of patients whose NRS decreased by 2 points or more, while the secondary outcome measures were the lumbar Oswestry dysfunction index(ODI), the proportion of patients whose ODI score decreased by 15 points or more, and the Macnab criteria.Results:Patients who met the inclusion criteria were divided into an RF group and a control group, with 135 patients in each group, including 171 women and 99 men.Compared with baseline values, changes in NRS scores in the RF group were significantly different from those in the control group at the 1st, 3rd and 6th months[(-2.3±1.1) vs.(-1.2±1.2), (-2.3±1.1) vs.(-1.2±1.2), (-2.3±1.1) vs.(-1.2±1.2), t=13.204, 16.366, 20.319, all P<0.001], and the proportions of patients whose NRS decreased by ≥2 at the 3rd and 6th months were higher in the RF group than in the control group[61.1%(80/131) vs.26.0%(32/123), 52.9%(64/121) vs.22.5%(25/111), χ2=18.287, 11.844, both P<0.001]. Compared with baseline values, there were also significant differences in ODI score changes between the RF group and the control group at the 1st, 3rd and 6th months[(-15.2±6.7) vs.(-10.1±7.4), (-14.6±6.8) vs.(-8.6±6.2), (-13.6±8.8) vs.(-7.7±9.2), t=5.563, 8.912, 7.721, all P<0.001], and the proportions of ODI reduction ≥15 were higher in the RF group than in the control group at the 3rd and 6th months[45.8%(60/131) vs.34.1%(42/123), 36.4%(44/121) vs.27.0%(30/111), χ2=6.668, 9.825, P=0.024, 0.031]. The proportions of patients achieving outcomes categorized as excellent and effective based on the Macnab criteria were significantly higher in the RF group than in the control group at the 6th month[60.3%(73/121) vs.36.0%(40/111), 81.0%(98/121) vs.54.1%(60/111), χ2=11.787, 8.890, both P<0.001)]. Conclusions:Minimally invasive radiofrequency thermocoagulation in the posterior medial branch of the spinal nerves can effectively reduce pain of the lumbar facet joints and improve movement disorders in the elderly, and the therapeutic effect is good 6 months after the procedure.

Efficacy evaluation of radiofrequency thermocoagulation and pulse radiofrequency for the ganglion impar in treating primary perineal pain / 西安交通大学学报(医学版)

【Objective】 To compare the efficacy of radiofrequency thermocoagulation and pulsed radiofrequency for the ganglion impar in treating primary perineal pain. 【Methods】 We analyzed 79 patients with primary perineal pain who underwent radiofrequency thermocoagulation (group A) and pulsed radiofrequency (group B) in the ganglion impar from January 2020 to March 2022. VAS, excellent and good rates, sleep quality, postoperative medication usage, complications, and recurrence were evaluated before and 24 h, 1 W, 1 M, 3 M and 6 M after operation. The differences between the two groups were compared. 【Results】 The VAS score of group A gradually decreased at each level after operation, and the VAS score of group B gradually increased after 24 hours of operation. The differences between the two groups began to appear 1 week after operation, and the differences further increased with the extension of time (P<0.001). In six months after follow-up, the excellent and good rates of group A (86%) was significantly higher than that of group B (22%). In addition to postoperative perineal skin numbness, group A was superior to group B in improving sleep, postoperative oral medication (pregabalin and opioids), and disease recurrence (P<0.05). 【Conclusion】 Radiofrequency thermocoagulation for the ganglion impar can improve the quality of life by reducing pain, improving the excellent and good rates, improving sleep, and reducing recurrence a medication. The effect is better than that of pulsed radiofrequency.

Thermocoagulation as a Surgical Approach for the Treatment of Obsessive-Compulsive Disorder in Refractory Patients: Systematic Review

Obsessive-compulsive disorder (OCD), a disabling chronic neuropsychiatric disease, entails high economic costs to society and has high morbidity and mortality rates. The first-line treatments for OCD are selective serotonin reuptake inhibitors and cognitivebehavioral therapy. However, this disorder has the highest refractory index to noninvasive treatment. Alternatively, ablative thermocoagulation neurosurgical techniques have shown efficacy and few adverse effects. The present systematic review aimed to identify validated protocols to observe the effectiveness of ablative procedures in the treatment of severe and refractory OCD, as well as their possible adverse effects and benefits. This review supports the effectiveness of ablative methods by presenting them as a safe non-experimental therapeutic option for cases of highlyrefractory OCD. Additional relevant findings were the improvement in cognitive function, functional capacity, affective orientation, and quality of life, which contribute to the destigmatization of this surgical technique. Further controlled studies may lead to the individualization of recommendations of targets for ablative thermocoagulation.

Termocoagulación por radiofrecuencia de ganglio de Gasser para el tratamiento de neuralgia trigeminal, resultados de 11 años / Gasser's ganglion radiofrequency thermocoagulation for the treatment of trigeminal neuralgia, 11-year results

Objetivos: Describir resultados de los últimos 11 años en el tratamiento de neuralgia del trigémino con termocoagulación por radiofrecuencia, analizar variables relacionadas a complicaciones y resultados. Material y Métodos: Estudio retrospectivo, descriptivo, longitudinal, comparativo y analítico. Se analizaron los resultados de los últimos 11 años de nuestro servicio evaluando las temperaturas de las lesiones armando dos grupos, de 65°C-70°C y 71°C-75°C para analizar su relación con resultados y complicaciones. Resultados: Se trataron 59 pacientes en los cuales se realizaron 74 procedimientos, la edad media fue 59.22 años (±13,45). Se observó recidiva en 23 procedimientos con una tasa global de 31%. El tiempo medio de recidiva fue de 28,19 meses (±26,21). El tiempo medio de seguimiento fue de 33,10 meses (±33,49). El tiempo medio de evolución del dolor, previo al primer procedimiento, fue de 5,35 años (±4,37). Analizando los grupos se observó que no existía relación significativamente estadística (p = 0,74) entre el grupo de pacientes de 65ºC-70ºC y el grupo de 71ºC-75ºC y recidiva. No se observó relación estadísticamente significativa entre el grupo de 65ºC-70ºC y el grupo de 71ºC-75ºC y tiempo de recidiva (p=0,12). Se observó más pacientes con hipoestesia inmediata en el grupo de pacientes de 65ºC-70ºC, sin significación estadística (p=0,47). Conclusión: La termocoagulación por radiofrecuencia de ganglio de Gasser es un procedimiento accesible, mínimamente invasivo que demostró buenos resultados y buen manejo del dolor con bajo índice de complicaciones.

Objectives: Describe results of the last 11 years in the treatment of trigeminal neuralgia with radiofrequency thermocoagulation, analyze variables related to complications and results. Methods: Retrospective, descriptive, longitudinal, comparative and analytical study. The results of the last 11 years of our service were analyzed by assessing the temperatures of the lesions by assembling two groups, 65° C-70° C and 71 ° C-75° C to analyze their relationship with results and complications. Results: 59 patients were treated in which 74 procedures were performed; the mean age was 59.22 years (± 13.45). Recurrence was observed in 23 procedures with an overall rate of 31%. The average recurrence time was 28.19 months (± 26.21). The average follow-up time was 33.10 months (± 33.49). The average time of pain evolution, prior to the first procedure, was 5.35 years (± 4.37). Analyzing the groups, it was observed that there was no significant statistical relationship (p = 0.74) between the group of patients from 65ºC-70ºC and the group from 71ºC-75ºC and recurrence. No statistically significant relationship was observed between the 65ºC-70ºC group and the 71ºC-75ºC group and recurrence time (p = 0.12). More patients with immediate hypoaesthesia were observed in the group of patients from 65ºC-70ºC, without statistical significance (p = 0.47). Conclusion: Gasser's ganglion radiofrequency thermocoagulation is an accessible, minimally invasive procedure that demonstrated good results and good pain management with a low complication rate

3D printing navigation template-guided percutaneous radiofrequency thermocoagulation for V2 trigeminal neuralgia treatment / 华西口腔医学杂志

OBJECTIVE@#This paper aimed to evaluate the effectiveness of the 3D printing puncture navigation template-guided percutaneous radiofrequency thermocoagulation for V2 trigeminal neuralgia treatment.@*METHODS@#A total of 52 patients with V2 trigeminal neuralgia were treated with radiofrequency thermocoagulation. A total of 32 patients were treated under the guidance of the 3D printing puncture navigation template (guide plate group), while 20 patients underwent puncture via pterygopalatine fossa routinely (routine treatment group). The puncture time, operation time, puncture success rate, and immediate postoperative pain were recorded. The degree of immediate postoperative pain was indicated by visual analogue scale (VAS). Barrow Neurological Institute (BNI) classification criteria were used to evaluate the efficacy, and the postoperative complications were observed. All patients were followed up for 1 year.@*RESULTS@#The two groups showed significant decrease in VAS after the operation (P0.05).@*CONCLUSIONS@#3D printing puncture navigation template-guided radiofrequency thermocoagulation may increase the operation success rate and reduce complication incidence. Therefore, this technique possesses clinical promotional value.

CT-guided radiofrequency thermocoagulation of trigeminal nerve via foramen rotundum route: analysis of the three - dimensional puncture pathway and the influence factors / 介入放射学杂志

Objective Based on CT imaging measurements to investigate the relevant parameters of 3D positioning that are used for the puncturing of trigeminal nerve via foramen rotundum route, and to discuss the influences of gender, age, and BMI on the measurements of these parameters in order to improve the success rate of puncturing. Methods A total of 64 patients with trigeminal neuralgia (second branch), who were successfully treated with CT - guided radiofrequency thermocoagulation of trigeminal nerve via foramen rotundum route during the period from August 2015 to March 2017, were included in this study. Their CT images were retrospectively analyzed. The line from the opening of the external auditory canal to the root of the nose (ear-nose line) was used as the base line on sagittal plane, and the angle between the ear-nose line and the puncture needle (angle α) was measured. On transverse section drawing a line between the midpoint of nose bridge and the midpoint of the posterior edge of the ethmoid sinus (M line), the angle between M line and the puncture needle (angle β) was determined. The vertical distance from the midpoint of the foramen rotundum to M line(D1), the vertical distance from needle puncture point to M line(D2), and the puncture depth (D3) were respectively measured. Results The angle α varied from 44. 10° to 63. 50° with a mean of (55. 05°±5. 48°). The angle β ranged from 26. 42° to 68. 37° with an average of (38. 19°±8. 58°). The distance of D1 was (19. 55±2. 67) mm, the distance of D2 was (58. 50±5. 41) mm, and the depth of D3 was (64. 89+8. 21) mm. The gender, age and BMI value showed a close correlation with the puncture angle and the puncture depth (P＜0. 05), and no statistically significant differences in these indexes existed between the left side and the right side (P＞0. 05). Conclusion The angle a and the other puncture parameters can roughly determine the three dimensional spatial orientation of foramen rotundum, which can be further adjusted according to patient's gender, age and BMI value. (J Intervent Radiol, 2018, 27: 234-237)

Efficacy and safety of radiofrequency thermocoagulation with pulsed radiofrequency for V1 trigeminal neu-ralgia patients / 实用医学杂志

Objective To evaluate the efficacy and safety of radiofrequency thermocoagulation with pulsed radiofrequency for V1 trigeminal neuralgia patients. Methods The prospective cohort study enrolled 70 patients with V1 primary trigeminal neuralgia,who were admitted to Pain Department,Hangzhou First People′s Hospital from January to December 2012. The patients were divided into RF group(n = 35)and RF plus PRF group(n =35)and followed up for 3 years for pain relief rate and complications. Results Postoperative cure rate of immedi-ate pain in RF group was 88.57%(BNI class I,II)and that in RF plus PRF group 91.43%(BNI class I,II).The pain relief rate was higher in RF plus PRF group,and the difference was statistically significant(χ2=5.178,P=0.023). Fourteen patients in RF group suffered corneal hypoesthesia and their recovery time was(12.1 ± 7.5) months and 6 in RF plus PRF group experienced corneal hypoesthesia and their recovery time was(8.9 ± 2.3) months.The differences of incidence rate and recovery time were significant(χ2=4.48,P=0.034;t=2.25,P=0.028). Conclusions RF plus PRF is conducive to decreasing the recurrence of V1 trigeminal neuralgia,reduc-ing the numbers of corneal hypoesthesia and shortening the recovery time,which is worth of clinical promotion.

Cirugía de tiroides. Revisión histórica y nuevas tecnologías / Thyroid surgery. Historical review, new technologies

El trabajo repasa la evolución histórica en el entendimiento y en el manejo de la cirugía tiroidea. Describe los orígenes de esta cirugía y su ejecución, mucho antes de que se entendiera el funcionamiento de la glándula. Enumera los personajes más trascendentes de esta historia y cómo otras técnicas aplicadas en la cirugía oncológica general se adaptaron a la cirugía de cabeza y cuello. Se mencionan las innovaciones tecnológicas en cirugía tiroidea.

This work reviews the historical evolution of thyroid surgery, its understanding and management. It mentions the origins of this surgical procedure and its execution well before the understanding of the glandular function. The leading persons in this historical field are enumerated; and a review is made of how other techniques applied in surgical oncology were adapted in head and neck surgery. Technological innovations in thyroid surgery are enumerated.

Clinical observation of percutaneous interventional radiofrequency thermocoagulation target ablation combined with nerve block in the treatment of 150 cases of intervertebral disc herniation / 中国生化药物杂志

Objective To explore the effect of percutaneous interventional radiofrequency thermocoagulation target ablation combined with nerve block in the treatment of lumbar disc herniation, and to provide reference for clinical application. Methods Randomly selected from May 2015 to May 2017 treatment of lumbar disc herniation in 150 cases, according to the different treatment methods were divided into observation group and control group. The observation group of 78 cases, including percutaneous interventional radiofrequency thermocoagulation target ablation combined with nerve block treatment; the control group of 72 cases, simply accept the nerve block treatment. The degree of lumbar dysfunction was evaluated by Osw estry Lumbar Dysfunction Index (ODI) before and after treatment. The efficacy of the two groups was evaluated by modified MacNab score. Adverse reactions were observed during the two groups. Results There was no significant difference between the two groups. After 2 weeks of treatment, the scores of ODI were significantly lower than those before treatment (P<0.05). The ODI score of the observation group was significantly lower than that of the control group (P<0.05). The effective rate was 96.2% (75/78) and the excellent and good rate was 91.03% (71/78). The effective rate was 90.28% (65/72) and the excellent and good rate was 65.28% (47/72). The excellent and good rate of the observation group was significantly higher than that of the control group (P<0.05). There were no significant adverse reactions in the two groups. Conclusion Percutaneous interventional radiofrequency thermocoagulation target ablation combined with nerve block treatment of lumbar disc herniation significantly, high safety.

Effects of Radiofrequency Thermocoagulation on Patients with Refractory Supraorbital Neuralgia / 中国康复理论与实践

Objective To observe the effect of radiofrequency thermocoagulation on patients with refractory supraorbital neuralgia Methods From February, 2007 to September, 2014, 36 patients with refractory supraorbital neuralgia following ineffective conservative ther-apy including medicine and nerve blockade underwent radiofrequency thermocoagulation. Numeric Rating Scale (NRS), Patient Satisfaction Scale (PSS), onset time, effective rate, recurrence rate, additional carbamazepine dosage and side effects were recorded before, and one day, one month, three months, six months, one year, two years after treatment. NRS=0 or 50%diminution was considered effectively. Results It worked two days on average (zero to seven) after treatment. The NRS score decreased (P<0.05) and the PSS score increased (P<0.05) com-pared with the data before treatment. The effective rate was 100%within six months. The recurrence rate was 11.1%within two years. Sec-ond radiofrequency thermocoagulation treatment still worked for the recurrent patients. No other side effect was observed, except permanent frontal numbness, short-time palpebral edema and ecchymosis. Conclusion Radiofrequency thermocoagulation is effective on refractory su-praorbital neuralgia, and the side effects are tolerable so it is an alternative choice for patients experiencing invalid conservative therapy.

The application and research of Xueshuantong combined with radiofrequency thermocoagulation on the treatment of low back pain caused by lumbar degeneration / 中国生化药物杂志

Objective To investigate the value of Xueshuangtong combined with radiofrequency thermocoagulation in the treatment of lumbar degenerative lumbar pain.MethodsFrom January 1, 2014 to December 30, 2015, 60 patients with lumbar degenerative low back pain admitted in Jiashan Traditional Chinese Medicine Hospital.All of them were randomly divided into observation group and control group, and each with 30 cases.All patients received radiofrequency thermocoagulation, while the observation group received Xueshuantong for further treatment.All of the patients were assessed by the international Pain Association recommended the use of visual analogue scale (VAS) and McGill pain questionnaire (SF-MPQ) and CRP when treatment before starting and after 1, 3, 7, 14, 30 and 90d of the treatment.ResultsThere were no significant differences between the two groups in VAS, SF-MPQ and CRP before treatment (P<0.05).However, when compared with the control group, patients in the observation group got significantly lower levels of VAS at 1, 3, 7 and 14d after the operation;significantly lower levels of SF-MPQ at 1, 3, 7, 14 and 30d after the operation;and significantly lower levels of CRP at 14, 30 and 90d after the operation (P<0.05).And we found no serious complications occurred in the two groups.ConclusionThe Xueshuantong combined with radiofrequency thermocoagulation treatment of lumbar facet joint is a safe, effective and inexpensive for the low back pain which caused by lumbar degeneration.

Correlation between electrical stimulus intensity and postoperative complications of puncture trigeminal ganglion radiofrequency thermocoagulation / 实用医学杂志

Objective To investigate the relationship between electrical stimulus intensity and postopera-tive complications of puncture trigeminal ganglion radiofrequency thermocoagulation (PTGRT). Methods 86 pa-tients with trigeminal neuralgia (TN) on the second and the third branch underwent trigeminal ganglion radiofre-quency thermocoagulation in Xuanwu Hospital , Capital Medical University from June 2013 to December 2015 enrolled in this study. Electrical stimulus intensity in surgery and postoperative pain VAS score , numbness score, masseter muscles score and complications were recorded at 0, 24 and 48 hours post-surgery. Correlations among electrical stimulus intensity in surgery and postoperative pain VAS score,numbness score, masseter mus-cles score were analyzed. Result The 86 patients had different degrees of facial numbness , some patients had different degrees of masseter weakness , and 2 patients had mild sialorrhea in two days after PTGRT without serve complications. Eighty-three patients (96.51%) had no pain, and VAS score wass 0 at 0, 24 and 48 hours post-PTGRT. Electrical stimulus intensity in surgery had apparent negative correlation with numbness score at 0 , 24 and 48 hours popst-PTGRT (P < 0.01), with negative correlation with masseter muscles decreasing at 48 hours post-PTGRT (P < 0.05). Conclusion Suitable temperature and time in PTGRT were needed to be chose ac-cording to the electrical stimulus intensity.

The clinical application and nursing of percutaneous and ganglion radiofrequency treatment in the elderly patients of trigeminal neuralgia / 中国基层医药

Objective To explore the clinical curative effect and nursing measures of damaged skin and ganglion radiofrequency thermal condensation in the treatment of elderly primary trigeminal neuralgia.Methods 144 elderly patients with trigeminal neuralgia were randomly divided into observation group and control group,72 cases in each group.The control group was given percutaneous and ganglion radiofrequency thermal condensation damage to surgical treatment,the observation group was given in combination with the comprehensive nursing intervention.The clinical treatments of the two groups were observed.Results After the intervention,the anxiety self -assessment rating scale, depression self rating scale score of the observation group were (41.88 ±1.04)points,(44.19 ±2.15)points which of the control group after the intervention were (45.86 ±2.47)points,(51.08 ±3.97)points,the differences between the two groups were statistically significant (t =12.601,12.949,all P <0.05).In observation group,the length of hospital stay,visual analog pain score,nursing satisfaction score were (16.71 ±1.64)d,(1.48 ± 0.51)points,(94.58 ±2.43)points,which of the control group were (23.86 ±2.96)d,(3.26 ±1.14)points, (88.17 ±5.87)points,the differences between the two groups were statistically significant (t =17.928,12.093, 8.561,all P <0.05).The incidence rate of postoperative complications of the observation group was 5.56%,which of the control group was 16.67%,the difference between the two groups was statistically significant (χ2 =4.500,P <0.05).Conclusion Damaged on percutaneous and ganglion radiofrequency thermal condensation in treatment of elderly patients of primary trigeminal neuralgia with comprehensive nursing intervention can effectively relieve psycho-logical negative emotions,shorten hospitalization time,the patients'pain score,reduce the postoperative complications, it is worthy of popularization and application in clinic.

Clinical effect of ozone combined with radiofrequency thermocoagulation for the treatment of cervical interver-tebral disc herniation / 局解手术学杂志

Objective To analyze the treatment effects of cervical disc herniation treated by ozone combined with radiofrequency ther-mocoagulation. Methods Ninety cases of cervical intervertebral disc herniation were collected from our hospital in July 2009 to December 2013,who were treated by ozone combined with radiofrequency thermocoagulation. The patients were followed up for at least 3~6 months and the improvement rate was calculated according to the Macnab improved standard. Results All the patients were followed up for at least 3~6 months,according to the Macnab standard improved,50 cases were excellent,good in 25 cases,in 10 cases and poor in 5 cases,the improve-ment rate was 94. 4%. Conclusion The treatment of cervical disc herniation by ozone combined with radiofrequency thermocoagulation is one of the interventional therapy methods,which is minimally invasive and relatively safe. The treatment method has the following advantages, such as,satisfactory effect,accurate operation safety,less complications and without destroying the stability of the spinal structure.

Clinical observation of radiofrequency thermocoagulation of lumbar sympathetic ganglia combined with pregabalin in treatment of complex regional pain syndrome / 重庆医学

Objective To observe the efficacy and safety of radiofrequency thermocoagulation of lumbar sympathetic ganglia combined with pregabalin in the treatment of complex regional pain syndrome(CRPS).Methods 26 patients with lower limb CRPS were selected and treated by the radiofrequency thermocoagulation of lumbar sympathetic ganglia combined with oral pregabalin capsule.The visual analogue scale (VAS)and the quality of sleep(QS)were adopted to evaluate the pain change before treatment and on 1,7,14,28,56 d after treatment.The temperature change of lower limb skin and the occurrence situation of adverse reactions were recorded.Results Compared with before treatment,the scores of VAS and QS at different time points after treatment were decreased significantly (P <0.05),the skin temperature of affected lower limb after treatment was increased significantly (P <0.05).The total effective rates on 28,56 d after treatment were 88.46% and 96.15% respectively.The adverse reactions were mainly dizziness and somnolence.No severe complications such as vascular,neural and intra-abdominal organs injury were found in the treatment process.Conclusion The radiofrequency thermocoagulation of lumbar sympathetic ganglia combined with pregabalin in the treatment of CRPS can rapidly alleviate pain,improve the patients′quality of sleep and living.

Radiofrequency Thermocoagulation Combined with Ozone Intradiscal and Extradiscal Injection in the Treatment of Failed Back Surgery Syndrome：Report of 58 Cases / 中国微创外科杂志

Objective To explore the clinical effects and safety of radiofrequency thermocoagulation combined with ozone injection in the treatment of failed back surgery syndrome (FBSS). Methods A total of 58 patients suffered from FBSS were treated with radiofrequency thermocoagulation and ozone injection from October 2006 to December 2012.The changes of lumbar and leg functions were observed .The evaluation of clinical efficacy was made by visual analogue scale ( VAS) and Oswestry disability index (ODI) at one week, one month, three months, six months, and twelve months postoperatively , respectively. Results The operation was successfully completed in all the 58 patients , without serious complications .All the cases were followed for one year .The ODI was 20.3 ±3.1 at the last follow-up, which was significantly lower than that before operation (79.8 ±2.6, t=96.871, P=0.000).The VAS of back pain was (7.6 ±0.4) points preoperatively and (3.1 ±0.2) points at the last follow-up, which also showed statistical significance (t=45.206, P=0.000).According to the modified MacNab criteria, clinical outcomes showed excellent in 18 cases and good in 23 cases, with an excellent and good rate of operation being 70.7% (41/58). Conclusion Treatment of FBSS by using radiofrequency thermocoagulation and ozone injection is an effective option .

Cervical cordotomy for the treatment of oncological pain / Cordotomia cervical para tratamento da dor oncológica: revisâo de literatura

Cordotomy consists in the discontinuation of the spinothalamic tract in the anterolateral quadrant of the spinal cord and aims to reduce the transference of nociceptive information in the dorsal horn of the grey matter of the spinal cord (CPME) for rostral units at the neural axis. Many modalities of cordotomy may be employed: anterior transdiscal between C4-C5; endoscopic infra mastoid tip between C1-C2; percutaneous guided by fluoroscopy infra mastoid tip between C1-C2; percutaneous guided by CT infra mastoid tip between C1-C2; open cordotomy by means of laminectomy. The main indication is for patients in advanced cancer disease with severe neuropathic pain bellow the neck in whom the period of survival due to cancer disease is inferior to 3-4 months. The results for immediate pain relieve ranges from 69% to 100% of the cases, while preoperative Karnofsky scores were 20 and 70, respectively versus post operative Karnofsky scores of 20 and 100 respectively; the difference was determined to be highly significant (p < 0.001).

A cordotomia consiste na discontinuação do trato espinotâmico no quadrante ântero-lateral da medula espinal e visa reduzir a transferência de informação nociceptiva no corno dorsal da substância cinzenta da medula espinal (CPME) para as unidades rostrais no neuroeixo. Muitas modalidades de cordotomia podem ser empregadas: transdiscal anterior entre C4-C5; endoscópica inframastoidea entre C1-C2; Percutânea inframastoidea entre C1-C2 guiada por fluoroscopia; percutânea inframastoidea entre C1-C2 guiada por TC; cordotomia aberta por laminectomia. A principal indicação é para pacientes com câncer avançado com dor neuropática severa abaixo do pescoço nos quais a sobrevida devido ao câncer é inferior a 3-4 meses. Os resultados para alívio imediato da dor varia de 69% a 100% dos casos, enquanto os escores de Karnofsky foram de 20 e 70 no período pré-operatório, para 20 e 100 no período pós-opertaório; a diferença foi estatisticamente significativa (p < 0.001).

Study on Pathology and Neurotransmitters of Esophageal Sphincter after Radiofrequency Thermocoagulation in Dogs / 天津医药

Objective To investigate the effects of radiofrequency thermocoagulation (RFT) on pathological features and the expressions of choline acetyltransferase (ChAT), vasoactive intestinal peptide (VIP) and nitric oxide synthase (NOS) at lower esophageal sphincter (LES) in family dogs. Methods A total of 15 dogs were randomly divided into three groups. Sham group underwent gastroscopy and was fed for 3 months (n=5). Dogs were given RFT and were fed for 24 h after RFT (n=5, RFT+24 h group). Dogs were given RFT and were fed for 3 months after RFT (n=5, RFT+3m group). The pathological changes of LES were observed after HE staining in three groups. The expressions of ChAT, VIP and NOS were detected by immunohistochemical method in three groups. Results Results of HE staining showed nearly the same tissues in Sham group and control group. There were active inflammatory reaction and structural damage in RFT+24 h group. The chronic in-flammatory reaction and structural remodeling were found in RFT+3m group. Immunohistochemistry showed that ChAT was significantly increased in RFT+3m group compare than that of Sham group. Values of VIP and NOS were significantly de-creased in RFT+3m group compare than that of Sham group (P<0.01). Conclusion The thickness and increased pressure of LES were found after RFT,which also caused changes in neurotransmitters of local tissues in dogs.

Bipolar Intra-articular Radiofrequency Thermocoagulation of the Thoracic Facet Joints: A Case Series of a New Technique

BACKGROUND: This study tests the hypothesis that of bipolar radiofrequency thermocoagulation of the thoracic facet joint capsule may provide a safe and effect method of pain control from thoracic facet origin. METHODS: Among patients suffering from localized mid back pain, nine patients with thoracic facet disease confirmed by magnetic resonance image and diagnostic thoracic facet block were enrolled. Bipolar radiofrequency ablation in the inferior aspect of the thoracic facet joint was done. Visual Analog Scale (VAS) was measured pre-intervention and 1 month post-intervention. Any complications and changes in amount of pain medication were recorded. RESULTS: Significant 47.6% reduction in VAS was noted at 1 month. There were no serious complications. CONCLUSIONS: Intra-articular bipolarradiofrequency thermocoagulation of the thoracic facet joint may be a technically easier and valid method of treating mid back pain of thoracic facet origin.

Ocular surface alteration after radiofrequency thermocoagulation therapy in trigeminal neuralgia / 中华实验眼科杂志

Background Radiofrequency thermocoagulation is one of the effective therapies for trigeminal neuralgia.Corneal nerve is important substance of radiofrequency thermocoagulation ocular surface,which support the normal structure and function of cornea.Most of corneal nerves come from ophthalmic branch of trigeminal nerve.However,the change of ocular surface microenvironment following radiofrequency thermocoagulation treatment in the patient with trigeminal neuralgiais unclear.Objective This study was to analyze ocular surface change after radiofrequency thermocoagulation therapy in patients with trigeminal neuralgia.Methods Twenty-eight eyes of 28patients with trigeminal neuralgia underwent radiofrequency thermocoagulation therapy were enrolled in this study.The contralateral eyes were regarded as the control group.The central corneal sensitivity,function of lacrimal secretion (Schiemer 1 test),tear break-up time(BUT),corneal fluorescence staining and laser scanning confocal microscopic examination were performed before and after surgery in operative eyes and compared with the fellow eye.Informed consent was obtained before any relevant medical procedure from each patient.Results No significant differences was found before surgery in the central corneal sensitivity,the Schiemer Ⅰ test,BUT,corneal fluorescence staining and densities value of corneal subepithelial nerve plexus between the treating eyes and fellow eyes(Z =-1.511,-1.119,-0.428,-0.378,-0.854; P =0.131,0.263,0.669,0.705,0.393).1n the third day after radiofrequencythermocoagulation therapy,compared with pre-treatment,no significant differences were seen in BUT result,Schirmer Ⅰ test and the score of ocular surface fluorescence staining (Z =-0.620,-0.315,-1.732;P =0.535,0.753,0.083).Corneal sensitivity and subbasal nerve density were lowed 3 days after surgery (Z =-2.708,-2.813 ; P =0.007,0.005).One month after treatment,differences of all indexes mentioned above showed statistical significance between treating eyes and fellow eyes(Z=-3.888,-2.373,-3.311,-2.535 ; P =0.000,0.018,0.001,0.011).The corneal subepithelial nerve was thinner and sparse and dendritic cells on the cornea were found in the eyes received radiofrequency thermocoagulation therapy.Conclusions The secretion of tears and the stability of tear film are poorer and the corneal sensitivity and subbasal nerve density are affected in a certain extent in the eye received radiofrequency thermocoagulation therapy.