However, these study results vary with respect to selection criteria, techniques used, and outcomes achieved ( 8, 9). Since radiofrequency (RF) neurotomy has been suggested by Schaerer in 1978 to treat the neck pain, sporadic reports have been reported ( 11 - 14). In particular, the zygapophyseal joints are identified to be related with chronic neck pain in 54% of the patients after whiplash injury ( 10). Recently, cervical zygapophyseal joint is highlighted as a possible source of chronic neck pain and referred pain in the upper arm ( 7 - 9). Meanwhile, cervical degenerative disorders have attracted little attention despite the increased prevalence of chronic neck and arm pain or cervicobrachialgia, along with the increased prevalence of degenerative spinal diseases. Accordingly, recent extensive researches have been focused on the degenerative spinal pain syndromes, yet mostly on the lumbar spine ( 3 - 6). The treatment for spinal pain is now pursued on higher demand. Moreover, its onset is more attributable to degenerative changes than to traumatic lesions. Unlike other diseases whose incidences have been diminished, the incidence of spinal pain has been increased ( 1, 2). It was therefore concluded that cervical medial branch neurotomy is considered useful therapeutic modality for the management of cervicobrachialgia in selected patients, particularly in degenerative zygapophyseal disorders.Įxtended life span has changed the pattern of disease prevalence. Four patients showed recurrence of pain between 6 and 12 months. Among total of 28 patients, nineteen (68%) reported successful outcome according to outcome criteria after 6 months of follow-up ( p=0.001), and eight (42%) of 19 patients reported complete relief (100%) of pain. The most common involvement of nerve branches was C4 (89%), followed by C5 (82%), C6 (75%), and C7 (43%). Average stimulation intensity was 0.45 V, ranging from 0.3 to 0.69, to elicit pain response in cervical medial branches. Pain distribution pattern was not significantly correlated with the results of diagnostic blocks. Demographic data, types of pain distribution, responses of double controlled blocks, electrical stimulation parameters, numbers and levels of neurotomies, and surgical outcomes were evaluated after mean follow-up of 12 months. Authors investigated the usefulness of radiofrequency (RF) neurotomies of cervical medial branches in patients with cervicobrachialgia and analyzed the factors which can influence the treatment outcome. Chronic neck and arm pain or cervicobrachialgia commonly occurs with the degeneration of cervical spine.
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