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Miñana JME, Mazzinari G, Llopis-Calatayud JE, Cerdá-Olmedo G. Efficacy of pulsed radiofrequency on the suprascapular and axillary-circumflex nerve for shoulder pain: A randomised controlled trial. Indian J Anaesth 2024; 68:473-479. [PMID: 38764950 PMCID: PMC11100644 DOI: 10.4103/ija.ija_1107_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 05/21/2024] Open
Abstract
Background and Aims Painful shoulder is one of the most frequent consultation causes. Multiple treatments have been described to relieve pain, restore range of motion and improve functionality. Methods This randomised clinical trial was conducted in 60 patients. The treatment group received combined pulsed radiofrequency (PRF) on suprascapular nerve (SN) and axillary-circumflex nerve (ACN). The control group received PRF on SN only. The primary outcome was pain intensity measured by the Numerical Rating Scale (NRS). The secondary outcomes were the Shoulder Pain and Disability Index (SPADI), the Constant-Murley range of motion scale and Disability of the Arm, Shoulder and Hand (DASH) scale. The patients were monitored at the baseline visit and at 1, 3, 6 and 9 months. A mixed ordinal regression model was estimated to evaluate the association between the study group and pain measured with NRS. Results A global decrease in pain at the end of the study was noted. The global baseline NRS was 8.4, and the global final NRS at 9 months of follow-up was 6.2. Combined PRF on SN and ACN was not associated with lower NRS pain scores compared to single SN PRF [odds ratio (OR) =1.04, 95% confidence interval (CI) 0.91-1.20, P = 0.507]. Secondary outcomes showed no significant differences: SPADI (OR = 1.04, 95% CI 0.92-1.18), Constant-Murley (OR = 1.01, 95% CI 0.90-1.14), DASH (OR = 1.04, 95% CI 0.92-1.17). Conclusion Combined PRF applied to SN and ACN was not superior to PRF applied to SN alone.
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Affiliation(s)
- José Miguel Esparza Miñana
- Escuela de Doctorado, Catholic University of Valencia San Vicente Mártir C/Guillem de Castro, 65, 46008 Valencia, Spain
- Department of Anaesthesiology and Pain Unit, Instituto Musculoesquelético Europeo (IMSKE), Valencia, Spain
- Research Group in Perioperative Medicine, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Guido Mazzinari
- Research Group in Perioperative Medicine, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Department of Anaesthesiology, Critical Care and Pain Treatment, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Jose Emilio Llopis-Calatayud
- Department of Anesthesiology, Critical Care and Pain Therapy at Hospital Universitario de la Ribera, Spain
- Anesthesiology, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, Spain
| | - Germán Cerdá-Olmedo
- Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, Spain
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Olinger C, Vest J, Tarasek M, Yeo D, DiMarzio M, Burdette C, Williams E, Khazen O, Pilitsis JG. MR thermometry imaging for low intensity focused ultrasound modulation of spinal nervous tissue. Magn Reson Imaging 2023; 101:35-39. [PMID: 37004795 PMCID: PMC10804415 DOI: 10.1016/j.mri.2023.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVES Previously in rodent and swine models, we have shown that external low intensity focused ultrasound (liFUS) can be used to modulate pain responses. To ensure no adverse heating events occur with liFUS modulation in a non-invasive manner, we perform initial work in swine to show that magnetic resonance thermometry imaging (MRTI) is capable of measuring <2.0 °C changes at the L5 DRG. Further, we show that our device can be constructed in an MR-compatible fashion to minimize artifact. METHODS Three MRTI techniques (referenceless, corrected proton resonance frequency shift (PRFS), and PRFS) were applied to assess accuracy of detecting thermal changes at the L5 DRG in unheated euthanized swine. A region of interest (ROI) that includes the L5 DRG was delineated, within which MRTI temperature changes were spatially averaged (ground truth 0 °C). In separate experiments with phantoms, B0 field-inhomogeneity, RF transmit (B1+) and fast gradient echo (fSPGR) magnitude images were acquired to downselect liFUS device materials that produce the least MRI artifacts. RESULTS Referenceless, corrected PRFS, and PRFS MRTI resulted in temperature measurements of 0.8 ± 1.1 °C, 1.1 ± 1.3 °C and 5.2 ± 5 °C, respectively. Both materials caused B0 perturbation but minimal B1+ and MRTI artifacts. The presence of imaging artifacts did not preclude thermal imaging of the region. SIGNIFICANCE We provide preliminary data suggesting that referenceless MRTI can adequately detect small thermal changes at the DRG that may occur with neuromodulation, which is one of the first steps in creating a table of safe parameters for liFUS therapy in humans.
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Affiliation(s)
- Clayton Olinger
- Department of Biomedical Science, Florida Atlantic University, Boca Raton, FL, United States of America
| | - Jonah Vest
- Department of Biomedical Science, Florida Atlantic University, Boca Raton, FL, United States of America
| | | | - Desmond Yeo
- GE Global Research, Niskayuna, NY, United States of America
| | - Marisa DiMarzio
- Department of Biomedical Science, Florida Atlantic University, Boca Raton, FL, United States of America
| | - Clif Burdette
- Acoustic Medsystems, Savoy, IL, United States of America
| | - Emery Williams
- Acoustic Medsystems, Savoy, IL, United States of America
| | - Olga Khazen
- Department of Biomedical Science, Florida Atlantic University, Boca Raton, FL, United States of America
| | - Julie G Pilitsis
- Department of Clinical Neurosciences, Florida Atlantic University, Boca Raton, FL, United States of America.
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Jia Y, Cheng H, Shrestha N, Ren H, Zhao C, Feng K, Luo F. Effectiveness and safety of high-voltage pulsed radiofrequency to treat patients with primary trigeminal neuralgia: a multicenter, randomized, double-blind, controlled study. J Headache Pain 2023; 24:91. [PMID: 37464283 DOI: 10.1186/s10194-023-01629-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/10/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Trigeminal neuralgia (TN) is a debilitating pain disorder that still lacks an ideal treatment option. Pulsed radiofrequency (PRF), especially with high output voltage, is a novel and minimally invasive technique. PRF is regarded a promising treatment option for TN patients who respond poorly to medical treatment; however, the available evidence still lacks high quality randomized controlled trials (RCTs). Our study aimed to evaluate the long-term (1 year and 2 years) effects and safety of high-voltage PRF in primary TN patients and provide stronger evidence for TN treatment options. METHODS We performed a multicenter, double-blind, RCT in adults (aged 18-75 years) with primary TN who responded poorly to drug therapy or were unable to tolerate the side effects of drug. Eligible participants were randomly assigned (1:1) to receive either high voltage PRF or nerve block with steroid and local anesthetic drugs. The primary endpoint was the 1-year response rate. This trial has been registered in the clinicaltrials.gov website (registration number: NCT03131466). RESULTS One hundred and sixty-two patients were screened for enrollment between April 28th,2017 and September1st, 2019, among whom, 28 were excluded. One hundred and thirty-four participants were randomly assigned to either receive high voltage PRF (n = 67) or nerve block (n = 67). The proportion of patients with a positive response at 1-year after the procedure in the PRF group was significantly higher than that in the nerve block group in the intention-to-treat population (73.1% vs. 32.8%, p < 0.001). There was no difference between groups in the incidence of adverse events. CONCLUSIONS Our findings support that high voltage PRF could be a preferred interventional choice prior to receiving more invasive surgical treatment or neuro-destructive treatment for TN patients who have poor responses to medical treatment. TRIAL REGISTRATION Our study has been registered at ClinicalTrials.gov (trial registration number: NCT03131466).
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Affiliation(s)
- Yitong Jia
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hao Cheng
- Department of Anesthesiology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Niti Shrestha
- Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hao Ren
- Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chunmei Zhao
- Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Kunpeng Feng
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Fang Luo
- Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Liss A, Hellman A, Patel VJ, Maietta T, Byraju K, Trowbridge R, Acheta J, Panse D, Srikanthan A, Neubauer P, Burdette C, Ghoshal G, Williams E, Qian J, Pilitsis JG. Low Intensity Focused Ultrasound Increases Duration of Anti-Nociceptive Responses in Female Common Peroneal Nerve Injury Rats. Neuromodulation 2022; 25:504-510. [PMID: 35667768 DOI: 10.1111/ner.13531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/12/2021] [Accepted: 08/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Chronic pain affects 7%-10% of Americans, occurs more frequently and severely in females, and available treatments have been shown to have less efficacy in female patients. Preclinical models addressing sex-specific treatment differences in the treatment of chronic pain have been limited. Here we examine the sex-specific effects of low intensity focused ultrasound (liFUS) in a modified sciatic nerve injury (SNI) model. MATERIALS AND METHODS A modified SNI performed by ligating the common peroneal nerve (CPN) was used to measure sensory, behavioral pain responses, and nerve conduction studies in female and male rats, following liFUS of the L5 dorsal root ganglion. RESULTS Using the same dose of liFUS in females and males of the same weight, CPN latency immediately after treatment was increased for 50 min in females compared to 25 min in males (p < 0.001). Improvements in mechanical pain thresholds after liFUS lasted significantly longer in females (seven days; p < 0.05) compared to males (three days; p < 0.05). In females, there was a significant improvement in depression-like behavior as a result of liFUS (N = 5; p < 0.01); however, because males never developed depression-like behavior there was no change after liFUS treatment. CONCLUSIONS Neuromodulation with liFUS has a greater effect in female rats on CPN latency, mechanical allodynia duration, and depression-like behavior. In order to customize neuromodulatory techniques for different patient phenotypes, it is essential to understand how they may alter sex-specific pathophysiologies.
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Affiliation(s)
- Andrea Liss
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Abigail Hellman
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Vraj J Patel
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Teresa Maietta
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Kanakaharini Byraju
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Rachel Trowbridge
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Jenica Acheta
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Drishti Panse
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Adithya Srikanthan
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | | | | | | | | | - Jiang Qian
- Department of Pathology, Albany Medical Center, Albany, NY, USA
| | - Julie G Pilitsis
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA; Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.
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Hellman A, Maietta T, Clum A, Byraju K, Raviv N, Staudt MD, Jeannotte E, Ghoshal G, Shin D, Neubauer P, Williams E, Heffter T, Burdette C, Qian J, Nalwalk J, Pilitsis JG. Pilot study on the effects of low intensity focused ultrasound in a swine model of neuropathic pain. J Neurosurg 2021; 135:1508-1515. [PMID: 33862597 PMCID: PMC10804417 DOI: 10.3171/2020.9.jns202962] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/28/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The authors' laboratory has previously demonstrated beneficial effects of noninvasive low intensity focused ultrasound (liFUS), targeted at the dorsal root ganglion (DRG), for reducing allodynia in rodent neuropathic pain models. However, in rats the DRG is 5 mm below the skin when approached laterally, while in humans the DRG is typically 5-8 cm deep. Here, using a modified liFUS probe, the authors demonstrated the feasibility of using external liFUS for modulation of antinociceptive responses in neuropathic swine. METHODS Two cohorts of swine underwent a common peroneal nerve injury (CPNI) to induce neuropathic pain. In the first cohort, pigs (14 kg) were iteratively tested to determine treatment parameters. liFUS penetration to the L5 DRG was verified by using a thermocouple to monitor tissue temperature changes and by measuring nerve conduction velocity (NCV) at the corresponding common peroneal nerve (CPN). Pain behaviors were monitored before and after treatment. DRG was evaluated for tissue damage postmortem. Based on data from the first cohort, a treatment algorithm was developed, parameter predictions were verified, and neuropathic pain was significantly modified in a second cohort of larger swine (20 kg). RESULTS The authors performed a dose-response curve analysis in 14-kg CPNI swine. Specifically, after confirming that the liFUS probe could reach 5 cm in ex vivo tissue experiments, the authors tested liFUS in 14-kg CPNI swine. The mean ± SEM DRG depth was 3.79 ± 0.09 cm in this initial cohort. The parameters were determined and then extrapolated to larger animals (20 kg), and predictions were verified. Tissue temperature elevations at the treatment site did not exceed 2°C, and the expected increases in the CPN NCV were observed. liFUS treatment eliminated pain guarding in all animals for the duration of follow-up (up to 1 month) and improved allodynia for 5 days postprocedure. No evidence of histological damage was seen using Fluoro-Jade and H&E staining. CONCLUSIONS The results demonstrate that a 5-cm depth can be reached with external liFUS and alters pain behavior and allodynia in a large-animal model of neuropathic pain.
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Affiliation(s)
- Abigail Hellman
- Departments of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York
| | - Teresa Maietta
- Departments of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York
| | - Alicia Clum
- Departments of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York
| | - Kanakaharini Byraju
- Departments of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York
| | - Nataly Raviv
- Department of Neurosurgery, Albany Medical College, Albany, New York
| | - Michael D. Staudt
- Department of Neurosurgery, Albany Medical College, Albany, New York
| | - Erin Jeannotte
- Department of Animals Resources Facility, Albany Medical College, Albany, New York
| | | | - Damian Shin
- Departments of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York
| | | | | | | | | | - Jiang Qian
- Department of Pathology, Albany Medical College, Albany, New York
| | - Julia Nalwalk
- Departments of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York
| | - Julie G. Pilitsis
- Department of Neurosurgery, Albany Medical College, Albany, New York
- Departments of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York
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Shoulder Ablation Approaches. Phys Med Rehabil Clin N Am 2021; 32:675-682. [PMID: 34593136 DOI: 10.1016/j.pmr.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The shoulder is structurally and functionally complex. Shoulder pain may be refractory to conventional treatments, such as physical therapy, pharmacotherapy, and corticosteroid injections. In such cases, radiofrequency ablation may serve as an alternative treatment plan. Current literature has demonstrated 4 target nerves for ablative therapy: the suprascapular nerve, axillary nerve, lateral pectoral nerve, and subscapular nerve. Special caution is needed when targeting these nerves in order to avoid motor denervation. This article summarizes the current evidence for radiofrequency ablation as a useful treatment option for chronic shoulder pain as well as the described techniques for performing this promising procedure.
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Fitterer JW, Picelli A, Winston P. A Novel Approach to New-Onset Hemiplegic Shoulder Pain With Decreased Range of Motion Using Targeted Diagnostic Nerve Blocks: The ViVe Algorithm. Front Neurol 2021; 12:668370. [PMID: 34122312 PMCID: PMC8194087 DOI: 10.3389/fneur.2021.668370] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/14/2021] [Indexed: 01/19/2023] Open
Abstract
Introduction: Hemiplegic shoulder pain (HSP) is the most common pain disorder after stroke with incidence estimates of 30–70% and associated with reductions in function, interference with rehabilitation, and a reduced quality of life. Onset may occur as soon as a week after stroke in 17% of patients. Management of HSP represents a complex treatment pathway with a lack of evidence to support one treatment. The pain has heterogeneous causes. In the acute setting, decreased range of motion in the shoulder can be due to early-onset spasticity, capsular pattern stiffness, glenohumeral pathology, or complex regional pain syndrome (CRPS). As contracture can form in up to 50% of patients after stroke, effective management of the painful shoulder and upper limb with decreased range of motion requires assessment of each possible contributor for effective treatment. The anesthetic diagnostic nerve block (DNB) is known to differentiate spasticity from contracture and other disorders of immobility and can be useful in determining an appropriate treatment pathway. Objective: To create a diagnostic algorithm to differentiate between the causes of HSP in the stiff, painful shoulder in the subacute setting using diagnostic techniques including the Budapest Criteria for CRPS and DNB for spasticity and pain generators. Results: Examination of each joint in the upper extremity with HSP may differentiate each diagnosis with the use of an algorithm. Pain and stiffness isolated to the shoulder may be differentiated as primary shoulder pathology; sensory suprascapular DNB or intra-articular/subacromial injection can assist in differentiating adhesive capsulitis, arthritis, or rotator cuff injury. CRPS may affect the shoulder, elbow, wrist, and hand and can be evaluated with the Budapest Criteria. Spasticity can be differentiated with the use of motor DNB. A combination of these disorders may cause HSP, and the proposed treatment algorithm may offer assistance in selecting a systematic treatment pathway.
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Affiliation(s)
- John W Fitterer
- Canadian Advances in Neuro-Orthopedics for Spasticity Congress, Victoria, BC, Canada
| | - Alessandro Picelli
- Canadian Advances in Neuro-Orthopedics for Spasticity Congress, Victoria, BC, Canada.,Section of Physical and Rehabilitation Medicine, Department of Neurosciences, Biomedicine and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona, Verona, Italy
| | - Paul Winston
- Canadian Advances in Neuro-Orthopedics for Spasticity Congress, Victoria, BC, Canada.,Division of Physical Medicine and Rehabilitation, University of British Columbia, Victoria, BC, Canada
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Divizia M, Germani G, Urti I, Imani F, Varrassi G, Meloncelli S. Endoscopic Neuromodulation of Suprascapular Nerve in Chronic Shoulder Pain: A Case Report. Anesth Pain Med 2020; 10:e103624. [PMID: 32754436 PMCID: PMC7352948 DOI: 10.5812/aapm.103624] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 04/14/2020] [Indexed: 12/16/2022] Open
Abstract
Shoulder pain is very frequent, especially in middle-aged male adults. Its treatment may be very problematic, mainly in patients who cannot rest and stop their work. At present, it is treated with analgesics, physiotherapy, infiltration of corticosteroids, and/or radiofrequency neuromodulation of the suprascapular nerve. This may be effective but not easy to do. Its efficacy is limited in time, especially because the approach to the nerve trunk may be problematic for its anatomical nature. Ultrasonography has helped, but it is not always completely helpful, due to the small dimension and the complexity of the anatomical structure. In this case report, we describe a more helpful approach to the nerve trunk using an endoscopic technique. The results are very promising. However, larger studies would be necessary to make clear its usefulness.
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Affiliation(s)
| | | | | | - Farnad Imani
- Pain Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Giustino Varrassi
- Paolo Procacci Foundation, Roma, Italy
- Corresponding Author: Paolo Procacci Foundation, Via Tacito 7, Roma, Italy
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Hellman A, Maietta T, Byraju K, Linda Park Y, Shao M, Liss A, Neubauer P, Burdette C, Ghoshal G, Qian J, Nalwalk J, Pilitsis JG. Low Intensity Focused Ultrasound Modulation of Vincristine Induced Neuropathy. Neuroscience 2020; 430:82-93. [DOI: 10.1016/j.neuroscience.2020.01.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 01/10/2020] [Accepted: 01/13/2020] [Indexed: 01/01/2023]
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Sir E, Eksert S. Ultrasound-guided pulsed radiofrequency neuromodulation of the suprascapular nerve in partial rotator cuff tears. Turk J Med Sci 2019; 49:1524-1528. [PMID: 31651124 PMCID: PMC7018394 DOI: 10.3906/sag-1906-132] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 08/25/2019] [Indexed: 12/02/2022] Open
Abstract
Background/Aim Pulsed radiofrequency (PRF) of the suprascapular nerve has been shown to be effective in the treatment of chronic shoulder pain. Ultrasound (US) guidance has gained popularity in regional blocks recently. This study aims to investigate the efficacy of suprascapular nerve pulsed radiofrequency under the guidance of ultrasonography. Materials and methods This retrospective study included patients treated with PRF of the suprascapular nerve with a diagnosis of partial rotator cuff tears. The patients were assessed with a numeric rating scale (NRS), the Shoulder Pain and Disability Index (SPADI), and a Likert patient satisfaction score before the treatment and 3 weeks and 6 months following the treatment. Results A total of 31 patients was included in the study. The patients’ mean age was 66.8 ± 13.3 years. The mean scores of the NRS,
SPADI, and Likert scale before the procedure (7.32 ± 1.1, 69.0 ± 8.5, 1.6 ± 0.6) and at 3 weeks (2.9 ± 2.1, 32.1 ± 17.20, 4 ± 1.2) and 6
months (3.2 ± 2.6, 33.9 ± 20.8, 3.8 ± 1.2) after the procedure were evaluated. We observed significant improvement in NRS, SPADI, and
Likert scores at 3 weeks and 6 months following the treatment (P < 0.001). Conclusion The study demonstrated that US-guided suprascapular nerve PRF achieves good pain relief and functional improvement
in patients with partial rotator cuff tears for at least 6 months.
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Affiliation(s)
- Ender Sir
- Department of Pain Medicine, Health Sciences University, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Sami Eksert
- Department of Anesthesia and Reanimation, Health Sciences University, Gülhane Training and Research Hospital, Ankara, Turkey
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