Samsung Medical Center, Seoul 135-710, Korea.
Pain Physician. 2010 Jan-Feb;13(1):43-9.
One technique in radiofrequency neurotomies uses 2 electrodes that are simultaneously placed to lie parallel to one another. Comparing lesions on cadaveric interspinous ligament tissue and measuring the temperature change in egg white allows us to accurately measure quantitatively the area of the lesion.
Fresh cadaver spinal tissue and egg white tissue were used. A series of samples were prepared with the electrodes placed 1 to 7 mm apart. Using radiofrequency, the needle electrodes were heated in sequential or simultaneous order and the distance of the escaped lesion area and temperature were measured.
Samples of cadaver interspinous ligament showed sequential heating of the needles limits the placement of the needle electrodes up to 2 mm apart from each other and up to 4 mm apart when heated simultaneously. The temperature at the escaped lesion area decreased according to the distance for egg white. There was a significant difference in temperature at the escaped lesion area up to 6 mm apart and the temperature was above 50 degrees celsius up to 5 mm in simultaneous lesion and 3 mm in the sequential lesion.
The limitations of this study include cadaveric experimentation and use of intraspinous ligament rather than medial branch of the dorsal ramus which is difficult to identify.
Heating the 2 electrodes simultaneously appears to coagulate a wider area and potentially produce better results in less time.
射频神经切断术中有一种技术使用两个电极,这些电极被同时放置,使其彼此平行。比较尸体棘间韧带组织上的病变和测量蛋清中的温度变化,使我们能够准确地定量测量病变面积。
使用新鲜的尸体脊柱组织和蛋清组织。在电极之间相距 1 至 7 毫米的位置制备一系列样本。使用射频,将针状电极顺序或同时加热,并测量逃脱病变区域的距离和温度。
尸体棘间韧带样本的结果表明,顺序加热针电极限制了针电极彼此之间的放置距离,最多可达 2 毫米,同时加热时最多可达 4 毫米。蛋清中逃离病变区域的温度随距离而降低。在相隔 6 毫米处的逃脱病变区域的温度有显著差异,并且在同时病变时温度超过 50 摄氏度,在顺序病变时温度超过 50 摄氏度可达 5 毫米,可达 3 毫米。
本研究的局限性包括尸体实验和使用棘间韧带,而不是难以识别的背侧支内侧分支。
同时加热两个电极似乎可以凝固更大的区域,并在更短的时间内产生更好的效果。