• Tom Ten Have, Sem T van Geffen, Willem A R Zwaans, Robbert C Maatman, BoelensOliver B AOBADepartment of Surgery, Maas Pantein Hospital, Boxmeer, The Netherlands., SteegersMonique A HMAH0000-0003-0812-5089Department of Anaesthesiology & Pain and Palliative Care, Amsterdam University Medical Center, Amsterdam, The Netherlands., ScheltingaMarc R MMRMDepartment of Surgery, Máxima Medical Center, Veldhoven, The Netherlands.SolviMáx Center of expertise for ACNES, Center of Excellence for Chronic Abdominal Wall and Groin Pain, Máxima Medical Center, Eindhoven, The Netherlands., and RoumenRudi M HRMHDepartment of Surgery, Máxima Medical Center, Veldhoven, The Netherlands.SolviMáx Center of expertise for ACNES, Center of Excellence for Chronic Abdominal Wall and Groin Pain, Máxima Medical Center, Eindhoven, The Netherlands..
• Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands.
• Pain Pract. 2024 Feb 1; 24 (2): 288295288-295.

PurposePatients with anterior cutaneous nerve entrapment syndrome (ACNES) often require a step-up treatment strategy including abdominal wall injections, pulsed radiofrequency (PRF) or a neurectomy. Long-term success rates of PRF and surgery are largely unknown. The aim of the current study was to report on the long-term efficacy of PRF and neurectomy in ACNES patients who earlier participated in the randomized controlled PULSE trial.MethodsPatients who completed the PULSE trial were contacted about pain status and additional treatments in the following years. Treatment success was based on numerical rating scale (NRS) following IMMPACT recommendations and Patient Global Impression of Change (PGIC) scores.ResultsA total of 44 of the original 60 patients were eligible for analysis (73.3%). Median follow-up was 71.5 months. One patient (4.3%) was still free of pain after a single PRF session, and five additional patients (21.7%) were free of pain by repetitive PRF treatments. By contrast, 13 patients (61.9%) in the neurectomy group were still free of pain without additional treatments. All pain recurrences and therefore primary re-interventions occurred in the first 2 years after the initial treatment.ConclusionApproximately one in five ACNES patients undergoing PRF treatment reports long-term success obviating the need of surgical intervention. Surgery for ACNES is long-term effective in approximately two of three operated patients. Recurrent ACNES beyond 2 years after either intervention is rare.© 2023 The Authors. Pain Practice published by Wiley Periodicals LLC on behalf of World Institute of Pain.

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