Ramanavarapu Vidya, Simopoulos Thomas T
Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA.
Pain Physician. 2008 Jul-Aug;11(4):561-6.
Chronic pain following limb amputations is now a recognized chronic pain syndrome usually described in a combination of phantom and stump pain. Both stump and phantom pain continue to be significant treatment challenges. If pharmacotherapy does not provide effective analgesia for stump pain, a clinician has interventional options that frequently give only transient benefit, or have a high chance of failure in the long run.
We selected 2 patients with primarily stump pain and difficulty tolerating the limb prosthesis. After a positive response to segmental nerve root blocks at L4 and L5, pulsed radiofrequency (PRF) was performed to the dorsal root ganglia (DRG).
Both patients experienced 50% pain relief or better for 6 months. Each patient tolerated the prosthetic limb and could function at a higher level.
PRF treatment of the DRG at the L4 and L5 nerve root level may be a therapeutic option for patients with peripherally mediated intractable stump pain. A decrease in pain intensity and improved toleration of the limb prosthesis was appreciated in both patients.
