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Lumbar Radiofrequency Ablation Interfering With S1 Dorsal Root Ganglion Stimulation Systems: Experience From Two Cases
Author(s) -
Chapman Kenneth B.,
Schirripa Frank,
Yousef Tariq,
Deygoo Jeffrey,
Helmond Noud
Publication year - 2020
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12901
Subject(s) - medicine , pulsed radiofrequency , neuromodulation , radiofrequency ablation , dorsal root ganglion , stimulation , lumbar , facet (psychology) , ablation , nociception , nerve root , ganglion , interventional pain management , complex regional pain syndrome , surgery , dorsum , anesthesia , anatomy , pain relief , pain management , psychology , social psychology , receptor , personality , big five personality traits
Background Dorsal root ganglion stimulation (DRG‐S) has emerged as a treatment for complex regional pain syndrome (CRPS) of the lower extremities, and recent small studies are demonstrating its potential efficacy in pain syndromes that are traditionally considered nociceptive in nature, such as axial low back pain. While improvements in neuromodulation technology have been substantial over the past decade, with DRG‐S systems patients occasionally require additional interventional pain treatments for treatment of pain from other sources. Radiofrequency ablation (RFA) of medial branch nerves innervating the facet joints is an accepted therapy for pain arising from the facet joints. Methods We describe 2 cases from the same practice where we observed similar phenomena while performing a 2‐needle monopolar lumbar RFA in patients with a DRG‐S system implanted with leads positioned bilaterally at the S1 DRGs. Results Initiation of RFA resulted in motor activation and discomfort in an S1 distribution in the legs in both individual cases. Conclusions RFA can interfere with implanted DRG‐S systems, resulting in overstimulation with motor recruitment. Specific anatomical considerations and device settings that may prevent interference are discussed.