Radiofrequency Coagulation of Percutaneous Dorsal Root Ganglionotomy(Case Report)

ABSTRACT

Streotaxic electrocoagulation of sensory pathway using radiofrequency currents is now a well established treatment mode for intractable pain control. However bilateral cordotomy, when needed, carry serious respiratory risks or motor deficit. Because of such problems, radiofrequency coagulation of dorsal root ganglia have been extended recently. We treated a case of intractable pain in both legs after spine injury with the radiofrequency dorsal root ganglionotomy. A 36 year-old male was admitted to our department complaining of severe intractable pain in oth legs. On neurological examination he was somewhat emaciated, both legs were paralysed below the knee joint with anesthesia below L4 dermatomes. Marked muscular atrophy on both legs were also observed. Bladder functions were preserved weakly. The patient was placed on the X-ray table in the prone position, 18 gauge spinal needle is directed under the radiographical control into the intervertebral foramen, so that the tip is halfway between inferior border of pedicle and upper border of superior articular process. Proper positioning of needle was tested by electrical stimulation and dorsal root ganglionotomy carried out at L4-5, L5-S1 interspaces using radiofrequency coagulation at 70 mA for 10 sec. And 30 mA for 10 sec. Postoperative results were satisfactoryv.