EFFECTS OF PRODUCING A RADIOFREQUENCY LESION ADJACENT TO THE DORSAL-ROOT GANGLION IN PATIENTS WITH THORACIC SEGMENTAL PAIN

Objective: To evaluate the effectiveness of a radiofrequency lesion ad jacent to the dorsal root ganglion (RF-DRG) on a consecutive group of patients presenting with chronic thoracic pain. Design: Retrospective study by a disinterested third party. Setting: Clinical outcome study. Patients: Forty-three patients with a minimum of 6 months history of unilateral thoracic segmental pain, unresponsive to conservative thera py were involved.Interventions: Patients were selected for a radiofreq uency lesion adjacent to the dorsal root ganglion after two or more pr ognostic nerve blocks had been performed under fluoroscopic control. T he level which provided the best analgesic response was selected. At t his level, a radiofrequency lesion was made at 67 degrees for 60 s imm ediately adjacent to the dorsal root ganglion. Outcome measures: Ratin g of pain was done on a four-step verbal rating scale. Results: A radi ofrequency lesion adjacent to the dorsal root ganglion provided short- term (8 weeks) relief of pain in 67% and long-term relief (>36 weeks) of pain in 52% of patients with a limited segmental distribution of pa in. If more than two segmental levels were involved, the procedure was found to be less effective. Conclusions: There was a significantly (p < 0.05) better short-term and longterm pain relief in patients with a clearly localized pain that was confined to one or two thoracic segme ntal levels, compared to patients with more than two segmental levels involved in the pain syndrome.