Manual of RF Techniques. A Practical Manual of Radiofrequency Procedures in Chronic Pain Management

Description

I said in my introduction to the 2nd edition of this book that the first edition of Manual of RF Techniques, which was printed in 2004, was a worldwide success and was also produced in Korean and Spanish editions. I was then asked to write a 2nd edition, which I did in 2008. Both editions have sold out, which is why I have been asked to produce this 3rd edition.

Radiofrequency and Pulsed radiofrequency are modalities which are used all over the world by interventional pain physicians; the techniques in use are constantly being refined and modified as more targets are located; in my writing, I always ensure that the Manual keeps up to date with recent developments.

I have added quite a lot of material to this edition, viz. alternative ways of targeting the lumbar facet joints, as well as the sacroiliac joint (the latter includes use of the Cosman™ Bipolar Palisade technique and of the Neurotherm™ Simplicity probe). I have added alternative ways of targeting the thoracic facet joints (using cool RF) and the thoracic dorsal root ganglia, alternative ways of targeting the cervical facet joints and the lateral atlanto-axial joint. I have also included pulsed radiofrequency of the pudendal, phrenic and coccygeal nerves. In addition the physics section has been rewritten and expanded.

I am very grateful for the contributions of Prof. Alex Cahana & his team, Prof. Eric R. Cosman Sr., Dr. Eric R. Cosman Jr., Prof. Phil Finch, Dr. Olav Rohof and Prof. Miles Day; these are all big names in interventional pain as well as being good drinking colleagues at WIP meetings! I am also very grateful to Enrico Cohen, the Managing Director of CoMedical who is publishing this edition. He has been extremely helpful in getting this project off the ground after the previous publisher Flivopress was acquired by the US-registered Neurotherm Ltd and was consequently recluded from the field of medical publishing under US law and surrendered copyright. Basia Jankowiak, my graphic designer has, yet again, provided her great skills to make this book what it is. Once again, I hope that interventional pain physicians across the world will continue to find this Manual of RF Techniques, useful to them in their daily practise of their chosen field.

Charles A. Gauci
London, UK
August 2011

Table of Contents

INTRODUCTION

A. THE PHYSICS OF RADIOFREQUENCY & PULSED RADIOFREQUENCY 16

Section 1: Dr. Eric R. Cosman Jr., Dr. Charles A. Gauci & Prof. Eric R. Cosman Sr. 16

Section 2: Prof. Eric R. Cosman Sr. & Dr. Eric R. Cosman Jr. 35

Section 3: Prof. Alex Cahana, Prof. Phillippe Richebe’& Dr. Cyril Rivat 39

B. RADIOFREQUENCY FACET JOINT DENERVATION

1. Cervical facets, including the technique of an alternative posterior approach to the cervical medial branch nerves, by Prof. Miles Day 54

2. Thoracic facets, including the use of Monopolar Cool RF 67

3. Lumbar facets, including a parallel approach to the lumbar medial branch nerves by Prof. Phillip Finch 78

4. Sacroiliac joint, including use of the Bipolar RF Palisade technique by Dr. Eric R. Cosman jr and the use of the Neurotherm Simplicity III™ RF probe 91

C. DORSAL ROOT GANGLION RADIOFREQUENCY/PULSED RADIOFREQUENCY

1. Cervical dorsal root ganglia 110

2. Thoracic dorsal root ganglia, including use of an alternative

technique 125

3. Lumbar dorsal root ganglia & S1 nerve 132

D. SYMPATHETIC NERVOUS SYSTEM RADIOFREQUENCY/PULSED RADIOFREQUENCY

1. Sphenopalatine ganglion 146

2. Superior cervical ganglion 152

3. Stellate ganglion 158

4. Thoracic sympathetic chain 163

5. Splanchnic nerves 167

6. Lumbar sympathetic chain 173

7. Ganglion Impar 182

E. MISCELLANEOUS PROCEDURES

1. Trigeminal ganglion radiofrequency 188

2. Intervertebral Disc needling & disc biaculoplasty 197

3. Pulsed radiofrequency of peripheral targets 205

- Occipital nerve 205

- Suprascapular nerve 207

- Other targets 209

> Upper limb

Gleno-humeral joint 211

Rotator Cuff 211

Humeral epicondyles 211

Elbow joint 212

Wrist joint 212

> Lower Limb

Hip Joint 212

Trochanteric bursa 212

Knee joint 213

Ankle Joint 213

Cluneal nerve 213

Lateral femoral cutaneous nerve 214

Coccygeal nerve 215

4. Percutaneous cervical RF Cordotomy 216

5. Atlanto-Occipital & Lateral Atlantoaxial joints, including the modified technique described by Dr. O. Rohof 223

6. Glossopharyngeal nerve 229

7. Phrenic nerve 231

8. Pudendal nerve 232