Kailash Kothari
Pain Clinic of India Pvt. Ltd., India
Title: Radiofrequency neurotomy for chronic cervical facet joint pain
Biography
Biography: Kailash Kothari
Abstract
Chronic neck and arm pain or cervicobrachialgia commonly occurs with the degeneration of cervical spine. Cervical medial branch block is commonly done pain management procedure for relieving this pain. We will discuss the application of radiofrequency (RF) neurotomies of cervical medial branches in patients with cervicobrachialgia and the factors which can influence the treatment outcome. Surgeon’s understanding of fluoroscopic anatomy is very important in placement of the RF needle, and in turn achieving better results. Demographic data, types of pain distribution, responses of double controlled blocks, and long term relief of pain after one or two diagnostic blocks, electrical stimulation parameters, numbers and levels of neurotomies, and surgical outcomes at 6 months are important parameters to discuss. It is recommended to do a good sensory and motor stimulation before ablation to improve the long term results. It is important to ablate a level above and below the suspected painful level to achieve good results. Cervical medial branch neurotomy is considered useful therapeutic modality for the management of cervicobrachialgia in selected patients, using good clinical and diagnostic pain management techniques in patients with degenerative zygapophyseal disorders.