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      Treatment Experience of Pulsed Radiofrequency Under Ultrasound Guided to the Trapezius Muscle at Myofascial Pain Syndrome -A Case Report-

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Trigger point injection treatment is an effective and widely applied treatment for myofascial pain syndrome. The trapezius muscle frequently causes myofascial pain in neck area. We herein report a case in which direct pulsed radiofrequency (RF) treatment was applied to the trapezius muscle. We observed that the RF treatment produced continuous pain relief when the effective duration of trigger point injection was temporary in myofascial pain.

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          Electric and thermal field effects in tissue around radiofrequency electrodes.

          Eric Cosman (2015)
          A study is carried out of the spatial distribution and time dependence of electric and thermal fields in the tissue around a radiofrequency (RF) electrode used in pain therapy. Finite-element calculation of the fields is performed, and results are compared with ex vivo tissue data. Field predictions are made for continuous and for pulsed RF applications. A special RF cannula electrode is constructed with both macro and micro thermocouple sensors to measure both average and rapid, transitory temperature effects. Temperatures and impedances are recorded in liver and egg-white models using signal outputs from a commercially available RF lesion generator. These data are compared with the results of finite-element calculations using electric field equations and the bio-heat equation. Average and pulsatory temperatures at the RF electrode are measured. Rapid temperature spikes during pulsed RF bursts are observed. These data compared well with theoretical calculations using known electrical and thermal tissue parameters. Continuous RF lesioning causes heat destruction of neurons. Pulsed RF lesioning (PRFL) produces heat bursts with temperatures in the range associated with destructive heat lesions. PRFL also produces very high electric fields that may be capable of disrupting neuronal membranes and function. Finite-element calculations agree substantially with the measured data, giving confidence to their predictions of fields around the RF electrode.
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            Exposure of the dorsal root ganglion in rats to pulsed radiofrequency currents activates dorsal horn lamina I and II neurons.

            B S Nashold, Eric Cosman, Menno Sluijter … (2002)
            Application of pulsed radiofrequency (RF) currents to the dorsal ganglion has been reported to produce long-term relief of spinal pain without causing thermal ablation. The present study was undertaken to identify spinal cord neurons activated by exposure of the dorsal ganglion to pulsed RF currents in rats. Left-sided hemilaminectomy was performed in adult Sprague-Dawley rats to expose the C6 dorsal root ganglion. An RF electrode (0.5 mm diameter) with a thermocouple for temperature monitoring was positioned on the exposed ganglion, and rats were assigned to one of three treatment groups: pulsed RF treatment (20 ms of 500-kHz RF pulses delivered at a rate of 2 Hz for 120 s to produce tissue heated to 38 degrees C), continuous RF (continuous RF currents for 120 s to produce tissue heated to 38 degrees C), or sham treatment (no RF current; electrode maintained in contact with ganglion for 120 s). Treatment with pulsed RF but not continuous RF was associated with a significant increase in the number of cFOS-immunoreactive neurons in the superficial laminae of the dorsal horn as observed 3 hours after treatment. Exposure of the dorsal ganglion to pulsed RF currents activates pain-processing neurons in the dorsal horn. This effect is not mediated by tissue heating.
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              Pulsed and continuous radiofrequency current adjacent to the cervical dorsal root ganglion of the rat induces late cellular activity in the dorsal horn.

              J G Veening, J N Munck, Hans Vles … (2004)
              Pulsed radiofrequency treatment has recently been described as a non-neurodestructive or minimally neurodestructive alternative to radiofrequency heat lesions. In clinical practice long-lasting results of pulsed radiofrequency treatment adjacent to the cervical dorsal root ganglion for the management of chronic radicular spinal pain have been reported without neurologic complications. However, the mode of action is unclear. An early (3 h) effect of pulsed radiofrequency as measured by an increase of c-Fos in the pain-processing neurons of the dorsal horn of rats has been described in the literature. This effect was not mediated by tissue heating. The authors investigated a possible late or long-term effect of three different radiofrequency modalities. Cervical laminectomy was performed in 19 male Wistar rats. The cervical dorsal root ganglion was randomly exposed to one of the four interventions: sham, continuous radiofrequency current at 67 centigrades, or pulsed radiofrequency current for 120 s or 8 min. The animals were sacrificed and the spinal cord was prepared for c-Fos labeling 7 days after the intervention. The number of c-Fos immunoreactive cells in the dorsal horn was significantly increased in the three different radiofrequency modalities as compared with sham. No significant difference was demonstrated between the three active intervention groups. The authors demonstrated a late neuronal activity in the dorsal horn after exposure of the cervical dorsal root ganglion to different radiofrequency modalities, which was not temperature dependent.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Korean J Pain
                Journal ID (publisher-id): KJP
                Title: The Korean Journal of Pain
                Publisher: The Korean Pain Society
                ISSN (Print): 2005-9159
                ISSN (Electronic): 2093-0569
                Publication date (Print): January 2012
                Publication date (Electronic): 02 January 2012
                Volume: 25
                Issue: 1
                Pages: 52-54
                Affiliations
                Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
                Author notes
                Correspondence to: Jong Bum Choi, MD. Department of Anesthesioligy and Pain Medicine, Gangnam Severance Hospital, 712, Eonju-ro, Gangnam-gu, Seoul 135-720, Korea. Tel: +82-2-2019-3520, Fax: +82-2-3463-0940, romeojb@ 123456yuhs.ac
                Article
                DOI: 10.3344/kjp.2012.25.1.52
                PMC ID: 3259139
                PubMed ID: 22259718
                SO-VID: dbb2e006-d14e-40e2-91d0-1e14e723e349
                Copyright © Copyright © The Korean Pain Society, 2012
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 30 September 2011
                Date revision received : 15 November 2011
                Date accepted : 15 November 2011
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: trigger point injection,pulsed rf (radiofrequency),myofascial pain
                Data availability:
                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: trigger point injection, pulsed rf (radiofrequency), myofascial pain

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