Open AccessBipolar Radiofrequency Neurotomy to Treat Neck and Back Pain in Patients with Automatic Implantable Cardioverter Defibrillator
Author(s) -
Alexander Bautista
Publication year - 2016
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj/2019.19.e505
Subject(s) - medicine , radiofrequency ablation , lumbar , neck pain , implantable cardioverter defibrillator , neurotomy , facet (psychology) , pulsed radiofrequency , catheter ablation , facet joint , back pain , surgery , ablation , anesthesia , cardiology , pain relief , psychology , social psychology , alternative medicine , personality , pathology , big five personality traits
We report 2 cases of successful treatment of neck and back pain with bipolar radiofrequencyablation (RFA) of the cervical and lumbar facet joints in patients with an automatic implantablecardioverter defibrillator (AICD).Two patients with complex cardiac histories and AICD devices were treated with bipolar RFAof the facet joints. One presented with axial neck pain and the other with axial back pain. Thehistories and physical examinations were consistent with facetogenic pain. Diagnostic medialbranch block resulted in more than 70% pain relief lasting for several days, allowing patientsto perform routine daily activities without significant pain. However, we were concerned aboutthe use of conventional RFA of the medial branches of nerves for the fear of interference withthe function of AICD by the RF currents and energy. We took advantage of the localized andlimited current of bipolar RFA to perform this procedure for the cervical or lumbar facet jointsavoiding any interference with the function of AICD. The procedures provided long-term painrelief to the patients, and marked improvement in their functional status without any evidentcomplications related to the function of their AICD.This case report describes the safe and successful completion of bipolar RFA of the medialbranch nerves to treat cervical and lumbar facetogenic pain in patients with AICD. This modalityof treatment may be considered in patients with AICD. We are finding it to be increasinglycommon that patients who present with chronic neck and back pain have AICDs in place.Key words: Back pain, neck pain, facet, AICD, radiofrequency neurotomy, bipolar lesioning