Pain medicine : the official journal of the American Academy of Pain Medicine
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Case Reports
COMBINED BIPOLAR AND V-SHAPED LESIONS FOR LUMBAR FACET RADIOFREQUENCY ABLATION: A TECHNICAL REPORT.
Radiofrequency ablation (RFA) is a demonstrated safe and effective treatment for chronic low back pain. RFA delivers high density electrical current near lumbar medial branch nerve. The success of RFA is contingent upon creating a lesion that overlaps the sensory nerve supplying the affected facet joint(s). Both bipolar-RFA and V-shaped active tip cannulas increase lesion size in experimental models. We describe successful application of concomitant bipolar and V-shaped lesions in a single patient with chronic low back pain caused by lumbar spondylosis. ⋯ We herein describe a technique of combined bipolar-RFA utilizing proximally adjacent V-shaped cannulas. Both bipolar and V-shaped cannulas create larger lesions in experiments. While both techniques purport theoretical advantages, the clinical superiority of a combined technique warrants continued clinical investigation.
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Neurovascular compression (NVC) in patients with trigeminal neuralgia (TN) can be a factor of treatment outcome, especially in microvascular decompression and stereotactic radiosurgery. No such effect has been reported in percutaneous radiofrequency rhizotomy (RF). This study aims to investigate whether NVC affects the efficacy of RF in patients with TN. ⋯ For patients with TN treated by RF, the presence or absence of NVC is not likely to affect the 1-year pain control rate.
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To assess risk factors for persistent neuropathic pain in subjects recovered from coronavirus disease 2019 (COVID-19) and to study the serum level of neurofilament light chain (NFL) in those patients. ⋯ Depression, azithromycin, and moderate and severe COVID-19 are independent predictors of persistent post-COVID-19 pain. Serum NFL may serve as a potential biomarker for persistent neuropathic pain after COVID-19.