The Therapeutic Effect of Radiofrequency Neurotomy after Nerve Block in Elderly Patients over 75 Years of Age

초록

Objective s: The goal of this study was to validate the therapeutic role of radiofrequency neurotomy after nerve block in elderly patients over 75 years of age. Methods A retrospective analysis was conducted based on the data obtained from 37 patients, 75 years or older, during three-year-period with painful condition in whom radiofrequency neurotomy was performed after nerve blocks. Causes of painful conditions were spinal stenosis, degenerative disc disease, compression fracture, facet syndrome and trigeminal neuralgia. Initially, 156 patients were treated with nerve block (medial branch block, dorsal root block, gray ramus communicans nerve block were included among various treatment option). Among 156 patients treated with nerve blocks, 37 patients (23.7%) showed either recurrent painful episodes following successful pain reduction from nerve blocks or remnants of substantial pain following various nerve blocks. In these 37 patients, radiofrequency treatments (conventional medial branch gangliotomy, and pulsed RF DRG gangliotomy) were per- formed. After 4 weeks, the outcome of pain procedures was analyzed by using Visual analog scale(VAS) along with degrees of patient satisfaction. Results All patients tolerated procedures well. Initial VAS score was 7.12. Thirty-seven of 156 patients (23.6%) underwent RF treatments. An average of 2.8 nerve blocks were done. Post-block VAS score was 5.4 in 37 patients and post-radiofrequency therapy VAS score 3.12. None of these patients required other surgical procedures during follow-up period. Thirty-three (89.1%) patients were satisfied with the treatments provided. There were no procedurerelated complications. Conclusion The radiofrequency therapy after nerve block procedures is considered as a safe and effective therapeutic option for even elderly patients over 75 years of age who show unsatisfactory to conservative managements including medication or physical therapy.

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