Radiofrecuencia pulsada: pasan los años y seguimos con las mismas incógnitas / Pulsed radiofrequency: the years go by and the questions remain the same

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Osteoma osteoide pélvico simulando sacroileitis / Pelvic osteoid osteoma simulating sacroiliitis

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Clinical Outcome Following Radiofrequency Denervation for Refractory Sacroiliac Joint Dysfunction Using the Simplicity III Probe: A 12-Month Retrospective Evaluation.

BACKGROUND: Sacroiliac joint syndrome (SIJ) is diagnosed in 10% to 25% of cases of lower back pain. The response to traditional radiofrequency (RF) denervation of the SIJ has being inconsistent. The Simplicity III RF probe (Neruotherm. Inc.) offers a novel treatment option. OBJECTIVE: To evaluate the long-term clinical outcome (12 months) refractory SIJ syndrome in terms of pain intensity and functional improvement. A 50% reduction in intensity pain intensity (VAS) at 12 months was deemed clinically significant. STUDY DESIGN: A 12-month retrospective observational evaluation all of adults treated with RF for refractory SIJ. SETTING: Chronic pain management center. METHODS: The medical records of all adults treated with this technique was retrospectively reviewed. The primary outcome was pain intensity scores (VAS) over a 12 months period; Secondary outcomes included Roland-Morris Functional scores (RMF), Brief Pain Inventory (BPI), general health assessment (Sf12), and patient satisfaction scores (GPI), which were recorded pre and post denervation. REULTS: Pain Intensity improved by 4.7 points compared to pre-treatment representing a 61% reduction in pain at 12 months (n=11, P < 0.001). Significant improvements in (a) RMF (P < 0.01, W2 = 0.63 (large effect size); (b) BPI (P < 0.001, W2 = 0.72 (strong effect size); and (c) Sf12 (P < 0.01) were noted. Overall patients were satisfied with the outcome (GPI = 77.7%). LIMITATIONS: The retrospective in nature of the study and the small sample size are limitations. As it was our policy to monitor the progress of the individuals since the introduction of this technique a reliable method of recording the baseline and outcome variables at each point of contact was in place. Access to a complete set of variables in all individuals over a 12-month period was therefore possible, which we feel contributes to the quality of the dataset. CONCLUSION: By creating a consistent radiofrequency lesion between the sacral foramen and the SIJ will reliably capture the innervation to the SIJ with significant long-term clinical improvement. This technique should be considered earlier in the treatment algorithm of individuals suffering from SIJ symptoms.

[The morphofunctional state of the polypous tissue under conditions of radiofrequency-wave and laser interstitial thermal therapy].

The objective of the present work was to evaluate the morphofunctional state of the polypous tissue under conditions of radiofrequency-wave (from 15 to 40 W) and laser interstitial (from 1 to 10 W) thermal therapy. It was shown that both techniques exerted no influence on the structure and physiology of epithelial glands, regardless of the regime chosen for their application. The therapeutic effect was achieved due to the influence of radiation on the loose connective tissue leading to the modification of its structure and the reduction of the volume of the polypous tissue. Laser interstitial thermal therapy at 3-7 W was found to be the most efficacious and injurious regime. In contrast, laser radiation over 7 W and radiofrequency-wave treatment (15-40 W) proved the most traumatic regimes. They cause coagulation and tissue necrosis at the sites of their direct application; these effects were strongly dependent on the radiation power.

A comparison of intraarticular lumbar facet joint steroid injections and lumbar facet joint radiofrequency denervation in the treatment of low back pain: a randomized, controlled, double-blind trial.

BACKGROUND: Lumbar facet joint degeneration is a source of chronic low back pain, with an incidence of 15% to 45% among patients with low back pain. Various therapeutic techniques in the treatment of facet-related pain have been described in the literature, including intraarticular lumbar facet joint steroid injections and radiofrequency denervation. In this study, we compared the effectiveness of intraarticular facet joint steroid injections and radiofrequency denervation. METHODS: Our randomized, double-blind, controlled study included patients who received intraarticular steroid infiltrations in the lumbar facet joints (L3/L4-L5/S1) and patients who underwent radiofrequency denervation of L3/L4-L5/S1 segments. The inclusion criteria were based first on magnetic resonance imaging findings showing hypertrophy of the facet joints L3/L4-L5/S1 and a positive response to an intraarticular test infiltration of the facet joints L3/L4-L5/S1 with local anesthetics. The primary end point was the Roland-Morris Questionnaire. Secondary end points were the visual analog scale and the Oswestry Disability Index. All outcome assessments were performed at baseline and at 6 months. RESULTS: Fifty-six patients were randomized; 24 of 29 patients in the steroid injection group and 26 of 27 patients in the denervation group completed the 6-month follow-up. Pain relief and functional improvement were observed in both groups. There were no significant differences between the 2 groups for the primary end point (95% confidence interval [CI], -3 to 4) and for both secondary end points (95% CI for visual analog scale, -2 to 1; 95% CI for Oswestry Disability Index, -18 to 0). CONCLUSIONS: Intraarticular steroid infiltration or radiofrequency denervation appear to be a managing option for chronic function-limiting low back pain of facet origin with favorable short- and midterm results in terms of pain relief and function improvement, but improvements were similar in both groups.

Técnicas ablativas: Radiofrecuencia y crioterapia ¿Cuál es la mejor? / Ablative techniques: radiofrequency and cryotherapy, which is the best?

La utilización generalizada de las técnicas radiológicas axiales abdominales durante la última década ha llevado a un aumento significativo del número de neoplasias corticales renales descubiertas incidentalmente. Entre las opciones de tratamiento ablativo disponibles la crioablación (CA) y la radiofrecuencia (RF) se han establecido como alternativas de la nefrectomía parcial (abierta/laparoscópica) factibles y viables. El objeto de este manuscrito es compararla RF con la CA. Para hacerlo, es de suma importancia entender completamente el dilema de las masas renales pequeñas tener un conocimiento práctico de cómo consiguen la destrucción celular estas masas(AU)

Over the last decade the widespread use of abdominal axial imaging has led to a significant rise in the number of incidentally discovered renal cortical neoplasms. Among the available treatment options for ablative therapies cryoablation (CA) and radiofrequency ablation (RFA) has established themselves as feasible and viable alternatives to partial nephrectomy (open/laparoscopic/robotic).The purpose of this manuscript is to compare RFA and CA. In order to do so, it is paramount to fully understand the small renal mass dilemma and to have a working knowledge as to how these technologies achieve cellular destruction(AU)

Lesiones del ganglio dorsal por radiofrecuencia pulsada a través del espacio epidural / No disponible

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Seeking an innocent method for pediatric septoplasty: in vivo comparison of Cottle's method, radiofrequency and laser in rabbits.

OBJECTIVES: In this study, in vivo histopathological and radiological findings in rabbit septum through laser, radiofrequency (RF) and Cottle's method were investigated. MATERIALS AND METHODS: This study was conducted between November 2007 and February 2008 on 36 New Zealand rabbits aged four-to-six months and weighing 1.5 to 2 kg. Subjects were divided into six equal groups. The first group was defined as the control group. Next four groups consisted of subjects where RF or laser was either applied transmucosal or directly to the cartilage. Cottle's method was used in the sixth group. Histopathological and radiological changes were investigated in each group. RESULTS: Histopathological changes in mucosa were not significantly different from those of control group. However, post-intervention changes in cartilage were significantly different, compared to the control group. The highest mucosal and submucosal reaction and damage in cartilage with ossification was found in Cottle group. It was found that radiofrequency was less damaging to mucosa, creating an equal degree of degeneration as laser in cartilage. CONCLUSION: Study results suggest that Cottle method is not so innocent with a considerable reaction rate, whereas RF and laser do not cause irreparable damage in cartilage and surrounding tissues. Radiofrequency seems superior to laser, as it causes more degeneration in cartilage, but no loss in epithelium even transmucosally. The major problem is the unpredictability of the damage.