• Pain physician · Aug 2021

    Cooled Radiofrequency Ablation of the Articular Sensory Branches of the Obturator and Femoral Nerves using Fluoroscopy and Ultrasound Guidance: A Large Retrospective Study.

    • Leonardo Kapural, Jeremy Naber, Kevin Neal, and Michael Burchell.
    • Carolinas Pain Institute, Winston-Salem, NC and Pain Fellowship Program, Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, NC.
    • Pain Physician. 2021 Aug 1; 24 (5): E611-E617.

    BackgroundWe previously reported on a combined technique and initial data of hip denervation using an anterior approach and cooled radiofrequency.ObjectivesA large retrospective study to evaluate the long-term effectiveness of cooled radiofrequency ablation (CRFA) in the general chronic hip pain population.Study DesignRetrospective electronic chart review.SettingA single specialty private practice.MethodsRetrospective chart review of 235 consecutive (CRFA) in 136 patients with chronic hip pain.ResultsOut of 235 CRFA, 178 (96 initial procedures and 82 repeats) were performed in 84 patients with 12 or more months follow-up. The average decrease in visual analog scale (VAS) pain scores was 7.3 ± 1.3 to 2.3 ± 1.5 and 2.48 ± 1.5 for the first and second diagnostic block, respectively, and was statistically significant (P < 0.001). Similarly, the average decrease in VAS pain scores at 6 and 12 months after CRFA denervation was 3.44 ± 2.5 and 4.23 ± 2.5, respectively; P < 0.001. Out of the 96 initial procedures in 84 patients, 66 procedures (69%) provided more than 50% relief at 6 months, and 50 (52%) at 12 months. There were 82 repeat denervations in 36 patients. Repeated procedures in the same patients provided a similar degree of pain relief with no statistically significant difference in the median pain scores (2.8 ± 2.1 cm vs 3.1 ± 1.7 cm ; P = 0.197) or time interval of pain relief (12.7 ± 10.9 vs 10.3 ± 4.7;  P = 0.508). There were 3 minor complications.LimitationsRetrospective nature of the study.ConclusionImprovements in pain scores and longevity of pain relief from chronic hip pain using a simple, anterior approach to radiofrequency denervation of the lateral obturator and lateral femoral nerves justifies further randomized prospective trials. Repeated CRFAs demonstrated consistency in pain relief and absolute safety of repeated denervation.

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