Abstract ID: A31
Abstract Title: Pulsed Radiofrequency as Therapy for Ilio-inguinal Neuralgia : Case Series and Retrospective Review
Authors: Haladjian R1, Bevenour J2, Haider N3, Wasserman R4
University of Michigan Health System Ann Arbor MI 1, University of Michigan Health System Ann Arbor MI 2, University of Michigan Health System Ann Arbor MI 3, University of Michigan Health System Ann Arbor MI 4
Poster Type: Either
ABSTRACT BODY
Introduction:
Ilioinguinal neuralgia is one of the most common causes of lower abdominal pain following hernia surgery.[1, 2] Surgical trauma, intense abdominal exercise, or inflammatory conditions may lead to entrapment of the nerve as it passes through the abdominal musculature. Pulsed radiofrequency of the dorsal root ganglion is an emerging non destructive treatment of various neuropathic pain conditions.[3]
Materials and Methods:
Following IRB approval, a retrospective chart review was conducted. Selection criteria included patients presenting to the Center for Interventional Pain Medicine at the University of Michigan with a diagnosis of ilio-inguinal neuralgia receiving pulsed radiofrequency as part of a treatment regimen. Variables assessed included patient demographics, etiology, duration, failed therapies, and response to treatment.
Results: The total number of patients included in this study was 22. The preliminary results showed that 15 patients had a good response to PRF (more than 50% pain relief for more than 2 months). 3 patients did not respond and 4 were lost to follow up.
Discussion: Prolonged relief of neuropathic pain is difficult to obtain in some patients.Treatment ranges from conservative medical therapy, peripheral nerve injections, to surgical neurolysis or release.[4, 5] Pulsed radiofrequency is postulated to include creation of an electric field that may alter neuronal conduction associated with induction of c-Fos immunoreactive cells.[6, 7] Objective evidence is lacking at present regarding the efficacy PRF as a treatment modality for ilio-inguinal neuralgia and randomized clinical trials are needed to further elucidate the role for this modality in clinical practice.[8]
1. Dittrick, G.W., et al., Routine ilioinguinal nerve excision in inguinal hernia repairs. Am J Surg, 2004. 188(6): p. 736-40.
2. Benini, A., [Ilio-inguinal and genito-femoral neuralgia. Causes, clinical aspects, therapy]. Schweiz Rundsch Med Prax, 1992. 81(38): p. 1114-20.
3. Erdine, S., et al., Effects of pulsed versus conventional radiofrequency current on rabbit dorsal root ganglion morphology. Eur J Pain, 2005. 9(3): p. 251-6.
4. Starling, J.R. and B.A. Harms, Diagnosis and treatment of genitofemoral and ilioinguinal neuralgia. World J Surg, 1989. 13(5): p. 586-91.
5. Amid, P.K., Causes, prevention, and surgical treatment of postherniorrhaphy neuropathic inguinodynia: triple neurectomy with proximal end implantation. Hernia, 2004. 8(4): p. 343-9.
6. Van Zundert, J., et al., Pulsed and continuous radiofrequency current adjacent to the cervical dorsal root ganglion of the rat induces late cellular activity in the dorsal horn. Anesthesiology, 2005. 102(1): p. 125-31.
7. Cosman, E.R., Jr. and E.R. Cosman, Sr., Electric and thermal field effects in tissue around radiofrequency electrodes. Pain Med, 2005. 6(6): p. 405-24.
8. Cohen, S.P. and A. Foster, Pulsed radiofrequency as a treatment for groin pain and orchialgia. Urology, 2003. 61(3): p. 645.
ATTACHED FILES
Reg Anesth Pain Med 2005; 30(3):A31