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ULTRASOUND GUIDED PULSED RADIOFREQUENCY OF THE SUPRASCAPULAR NERVE FOR CHRONIC SHOULDER PAIN.
ESRA Academy. Vriens D. Sep 8, 2016; 138500
Topic: PAIN THERAPY (ACUTE - CHRONIC)
Mrs. Debby Vriens
Mrs. Debby Vriens

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Abstract
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Background and Aims:

Pulsed radiofrequency treatment (PRF) of the suprascapular nerve (SSN) is a possible treatment of chronic shoulder pain (1).  Different techniques for approach of the SSN are described in the literature.  In this abstract we retrospectively describe our results with 20 ultrasound guided SSN PRF for refractory shoulder pain from October 2014 to March 2016.
 

Methods:

Using a high-frequency linear ultrasound transducer (GE Logiq E, GE Health Care Canada, Ontario, Canada), the SSN was identified in the supraclavicular region, where it passes underneath the omohyoid muscle as described by Siegenthaler et al. [3]

A 22-G needle with 5 mm active tip (RFTL Sono; Pajunk, Gaisingen, Germany) was positioned using ultrasound and confirmed by sensory threshold (≤ 0,3mA).

PRF was performed, after a diagnostic block with lidocaine 1%, (480 seconds, 42°C, 45 or 60V).

Follow-up after 6 to 8 weeks focused on changes of VAS scores and patient satisfaction.

Results:

Twelve out of seventeen (70.6%) patients had reduced pain scores. This is in line with earlier reports using the fluoroscopy approach in the supraspinous fossa [4].

(table 1) Frozen shoulder syndrome associated with fibromyalgia or depression had the least benefit of PRF.  

Similar reductions of VAS scores where registered using different voltage (45 versus 60 Volt).   

No complications were reported.

Conclusions:

US guided PRF SSN in the supraclavicular region, is a valuable technique for treatment of chronic shoulder pain after diagnostic block.

It would be interesting to look at the efficacy of different voltages in a future RCT. 

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