Journal of Pain Research (Sep 2021)

Latest Evidence-Based Application for Radiofrequency Neurotomy (LEARN): Best Practice Guidelines from the American Society of Pain and Neuroscience (ASPN)

  • Lee DW,
  • Pritzlaff S,
  • Jung MJ,
  • Ghosh P,
  • Hagedorn JM,
  • Tate J,
  • Scarfo K,
  • Strand N,
  • Chakravarthy K,
  • Sayed D,
  • Deer TR,
  • Amirdelfan K

Journal volume & issue
Vol. Volume 14
pp. 2807 – 2831

Abstract

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David W Lee,1 Scott Pritzlaff,2,3 Michael J Jung,2,3 Priyanka Ghosh,4 Jonathan M Hagedorn,5 Jordan Tate,6 Keith Scarfo,7 Natalie Strand,8 Krishnan Chakravarthy,9,10 Dawood Sayed,11 Timothy R Deer,12 Kasra Amirdelfan13 1Fullerton Orthopedic Surgery Medical Group, Fullerton, CA, 92831, USA; 2University of California, Davis; 3Division of Pain Medicine, Sacramento, CA, USA; 4ReMedy Medical Group, San Francisco, CA, USA; 5Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA; 6Alliance Spine and Pain Centers, Canton, GA, USA; 7Warren Alpert Medical School of Brown University Department of Neurosurgery - Norman Prince Spine Institute, Rhode Island Hospital, Providence, RI, USA; 8Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Phoenix, AZ, USA; 9University of California, San Diego; 10Division of Pain Medicine, San Diego, CA, USA; 11University of Kansas Medical Center, Kansas City, KS, USA; 12The Spine and Nerve Center of the Virginias, Inc., Charleston, WV, USA; 13IPM Medical Group, Inc., Walnut Creek, CA, USACorrespondence: David W LeeFullerton Orthopedic Surgery Medical Group, 680 Langsdorf Dr Suite 103, Fullerton, CA, 92831, USATel +1 714-879-0050Email [email protected]: Radiofrequency neurotomy (RFN), also known as radiofrequency ablation (RFA), is a common interventional procedure used to treat pain from an innervated structure. RFN has historically been used to treat chronic facet-joint mediated pain. The use of RFN has more recently expanded beyond facet-joint mediated pain to peripherally innervated targets. In addition, there has also been the emergence of different radiofrequency modalities, including pulsed and cooled RFN. The use of RFN has been particularly important where conservative and/or surgical measures have failed to provide pain relief. With the emergence of this therapeutic option and its novel applications, the American Society of Pain and Neuroscience (ASPN) identified the need for formal evidence-based guidance. The authors formed a multidisciplinary work group tasked to examine the latest evidence-based medicine for the various applications of RFN, including cervical, thoracic, lumbar spine; posterior sacroiliac joint pain; hip and knee joints; and occipital neuralgia. Best practice guidelines, evidence and consensus grading were provided for each anatomical target.Keywords: radiofrequency neurotomy, radiofrequency ablation, pulsed ablation, cooled ablation, sacroiliac joint neurotomy, peripheral joint neurotomy, occipital neuralgia, chronic pain

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