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Radiofrequency ablation of the facet joint and ganglion to treat chronic, severe, post traumatic thoracic pain
Author(s): ,
Quattrone, D.
Affiliations:
P.O. San Vincenzo Taormina - ASP Messina, Anesthesia and Pain Teraphy, Messina, Italy
,
Bova, G.
Affiliations:
P.O. San Vincenzo Taormina - ASP Messina, Anesthesia and Pain Teraphy, Messina, Italy
,
Micalizzi, S.
Affiliations:
A.O.U. Policlinico G. Martino, Anesthesia- Intensive Care and Pain Teraphy, Messina, Italy
,
Giacoppo, C.
Affiliations:
A.O.U. Policlinico G. Martino, Anesthesia- Intensive Care and Pain Teraphy, Messina, Italy
,
Cardia, L.*
Affiliations:
A.O.U. Policlinico G. Martino, Anesthesia- Intensive Care and Pain Teraphy, Messina, Italy
Mondello, E.
Affiliations:
A.O.U. Policlinico G. Martino, Anesthesia- Intensive Care and Pain Teraphy, Messina, Italy
ESRA Academy. Cardia L. Sep 13, 2017; 190725
Luigi Cardia
Luigi Cardia

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Abstract
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Background and Aims:

Medial branch radiofrequency neurotomy is a well established and effective procedure in pain management and also for ameliorate quality of life in suffering patients, presenting restrictive inclusion criteria to enroll patients.
Authors describe a successful treatment of chronic, severe, post traumatic pain in the thoracic region of rachis and a secondary radiculopaty of T5-T6 roots using both pulsed and continuous radiofrequency ablation.

Methods:

A 29 years old patient, after a trauma, developed a severe (NRS 10/10), chronic (over 26 months), disabling pain. Manifesting a primary spontaneous hyperalgesia in T5-T6 segment and a secondary hyperalgesia in the scapular region. Burning disesthesia and paresthesia were referred in T5-T6-T7 region, while mechanical allodynia was easily evoked with the contact of a cotton piece. Pain was unresponsive to the administration of major analgesic and also to peridural injection of local anesthetics. To be enrolled to the radiofrequency neurotomy of  T5-T6 facet joint, the patient was tested with an intra-articular administration of 5 mg of bupivacaine, under radiologic control, obtaining a referred pain relief of 60% compared to baseline value. The patient received a combined treatment of continuous radiofrequency of T5-T6 (to perform a neurotomy of  correspondent medial branch), and a pulsed radiofrequency ablation of T5-T6-T7 roots. 

Results:

Conclusions:

The patient reported immediate and significant pain relief: NRS 2/10 after 1h, 3/10 at 7th day, 4/10 at day 15th and 4/10 at day 30th. Pain relief continues for over 10 months. Other analgesics were gradually suspended. No adverse events or complications were recorded.

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