CT-Guided Percutaneous Pulse-Dose Radiofrequency for Pudendal Neuralgia

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• 作者：Salvatore Masala (1)
  Eros Calabria (1)
  Alessandro Cuzzolino (1)
  Mario Raguso (1)
  Marco Morini (1)
  Giovanni Simonetti (1)
  
• 关键词：Chronic perineal pain ; Chronic pain ; Clinical practice ; Pudendal neuralgia ; Pain ; Pulse ; dose radiofrequency ; Radiofrequency
• 刊名：CardioVascular and Interventional Radiology
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：37
• 期：2
• 页码：476-481
• 全文大小：729 KB
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• 作者单位：Salvatore Masala (1)
  Eros Calabria (1)
  Alessandro Cuzzolino (1)
  Mario Raguso (1)
  Marco Morini (1)
  Giovanni Simonetti (1)
  
  1. Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome - Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
  
• ISSN：1432-086X

文摘

Purpose The purpose of our study was to evaluate the efficacy of computed tomography (CT)-guided percutaneous pulse-dose radiofrequency (PDRF) for the treatment of chronic pain in patients with pudendal neuralgia (PN) unresponsive to conservative approaches. Methods From March 2010 to January 2012, 30 patients with a diagnosis of PN were prospectively enrolled in the study, 18 women and 12 men (mean age 47?years). A 20-gauge cannula with a 10-cm length was placed under CT guide in the pudendal (Alcock’s) canal. After the spindle was removed, a radiofrequency needle with a 5-mm active tip was introduced. The appropriate needle placement near the pudendal nerve, without an involvement of the vessels, was confirmed with an injection of 1-?ml of contrast agent. PDRF was performed with 1,200 pulses at high voltage (45?V) with 20?ms duration followed by 480?ms silent phases. Results Twenty-six patients completed the study. Procedural success was achieved in all patients. Mean VAS scores before PDRF was 9?±?0.7. Patients had a great improvement in pain intensity after 1?week by PDRF (mean VAS scores 3.8?±?1.7, p?<?0.05), with a stabilization of the symptomatology in the following months (mean VAS scores 1.5?±?1.1 at 6?months by PDRF, p?<?0.05) and excellent results after 1?year by the procedure (mean VAS scores 1.9?±?0.7, p?<?0.05). Conclusions In our preliminary experience, CT-guided percutaneous PDRF should be recommended for treatment of PN because we evaluated the tolerability of this procedure with satisfactory and encouraging results.