Liliang Po-Chou, Lu Kang, Liang Cheng-Loong, Tsai Yu-Duan, Hsieh Ching-Hua, Chen Han-Jung
Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
Pain Med. 2009 Jan;10(1):70-5. doi: 10.1111/j.1526-4637.2008.00543.x.
Chronic shoulder pain is difficult to treat, and the efficacy of most interventions is limited. This study was conducted to evaluate pulsed mode radiofrequency (PRF) lesioning of the suprascapular nerve for treating chronic shoulder pain. Interventions. Thirteen procedures using PRF lesioning of suprascapular nerve were performed under fluoroscopic guide in 11 patients (13 shoulder joints) with chronic shoulder pain for at least 3 months.
The patients were evaluated for pain, shoulder disability function, and medication requirements prior to and after treatment.
At 1-month follow-up assessment, 10 (76.9%) shoulder joints had significant pain relief (visual analog scale >or= 50% reduction), and at 6-month follow-up assessment, nine (69.2%) still had significant pain relief. The mean VAS score of 11 patients before PRF was 7.5 +/- 1.0, and the scores at 1-month and 6-month follow-up were 2.8 +/- 2.6 and 2.5 +/- 2.8, respectively. A significant pain reduction (P < 0.001) was observed. The mean Shoulder Pain and Disability Index scores at 6-month follow-up also showed a significant decrease compared with pre-PRF (P < 0.001). Medication requirements were evaluated 1 month and 6 months after the PRF. Nine (81.8%) patients had their medication requirement decreased.
Pulsed mode radiofrequency lesioning to suprascapular nerve is a potential treatment option for patients suffering chronic shoulder pain. It provides long-lasting pain relief and decreases pain medication requirements.
慢性肩痛难以治疗,大多数干预措施的疗效有限。本研究旨在评估肩胛上神经脉冲模式射频(PRF)毁损术治疗慢性肩痛的效果。干预措施:在透视引导下,对11例(13个肩关节)慢性肩痛至少3个月的患者进行了13次肩胛上神经PRF毁损术。
在治疗前后对患者的疼痛、肩部功能障碍和药物需求进行评估。
在1个月的随访评估中,10个(76.9%)肩关节疼痛明显缓解(视觉模拟评分降低≥50%),在6个月的随访评估中,9个(69.2%)仍有明显的疼痛缓解。11例患者PRF治疗前的平均VAS评分为7.5±1.0,1个月和6个月随访时的评分分别为2.8±2.6和2.5±2.8。观察到疼痛显著减轻(P<0.001)。6个月随访时的平均肩痛和功能障碍指数评分与PRF治疗前相比也显著降低(P<0.001)。在PRF治疗后1个月和6个月评估药物需求。9例(81.8%)患者的药物需求减少。
肩胛上神经脉冲模式射频毁损术是慢性肩痛患者的一种潜在治疗选择。它能提供持久的疼痛缓解并减少止痛药物需求。