Radiofrequency neurolysis in the management of inguinal neuralgia: preliminary study. 


Author: Kastler A, Aubry S, Barbier-Brion B, Jehl J, Kastler B.

Affiliation: Department of Radiology, Hôpital Gabriel Montpied CHU Clermont-Ferrand, 58 Rue Montalembert, F-63000 Clermont-Ferrand, France. adriankastler@gmail.com 
Conference/Journal: Radiology. 
Date published: 2012 Feb
Other:
 Volume ID: 262   ,  Issue ID: 2   ,  Pages: 701-7   ,  Word Count: 253  
    PURPOSE:

To evaluate the feasibility and efficacy of computed tomography (CT)-guided radiofrequency (RF) neurolysis (RFN) in the management of refractory inguinal neuralgia.

MATERIALS AND METHODS:

Local institutional review board approval was obtained and written informed consent was waived. Twelve patients 26-75 years of age with chronic (>6 months) inguinal pain refractory to specific medication were included between 2005 and 2011. Data on patient demographics, clinical history, and pain management history were retrospectively assessed. Pain was measured on a visual analog scale (VAS) from 0 to 10 before and immediately after the procedure and at 1, 3, 6, 9 and 12 months. Diagnosis was always confirmed by a positive nerve block test result. Ambulatory CT-guided RF was the rule.

RESULTS:

Sixteen RFN procedures were performed. Pain was present for an average of 3.2 years (range: 2-8 years) prior to initial RFN. Mean VAS score before the procedure was 7.75 of 10. Immediate pain relief of 100% was achieved in all patients. Pain reduction at 1-, 3-, 6-, 9-, and 12-month follow-up was statistically significant. Important pain reduction (≥80%) was obtained in 75% of RFN procedures at 6-month follow-up and in 50% of cases at 12 months. The mean duration of pain relief was 11.8 months after RFN, with a maximum average pain reduction of 84.5%. No complications were noted during or after the procedure.

CONCLUSION:

RFN with CT guidance is an effective technique in the management of refractory inguinal pain with lasting satisfactory pain reduction; it may be considered as an alternative treatment to surgery. These results should be confirmed in a controlled trial with a larger series of patients.

© RSNA, 2011

PMID: 22187627