J Korean Neurosurg Soc.  2013 Dec;54(6):507-510. 10.3340/jkns.2013.54.6.507.

Effect of Pulsed Radiofrequency Neuromodulation on Clinical Improvements in the Patients of Chronic Intractable Shoulder Pain

• Jang JS
• Choi HJ
• Kang SH
• Yang JS
• Lee JJ
• Hwang SM

• KMID: 2190947
• DOI: http://doi.org/10.3340/jkns.2013.54.6.507

Abstract

OBJECTIVE
The aim of this study was to evaluate effect of pulsed radiofrequency (PRF) neuromodulation of suprascpaular nerve (SSN) in patients with chronic shoulder pain due to adhesive capsulitis and/or rotator cuff tear.
METHODS
The study included 11 patients suffering from chronic shoulder pain for at least 6 months who were diagnosed with adhesive capsulitis (n=4), rotator cuff tear (n=5), or adhesive capsulitis+rotator cuff tear (n=2) using shoulder magnetic resonance imaging or extremity ultrasonography. After a favorable response to a diagnostic suprascapular nerve block twice a week (pain improvement >50%), PRF neuromodulation was performed. Shoulder pain and quality of life were assessed using a Visual Analogue Scale (VAS) and the Oxford Shoulder Score (OSS) before the diagnostic block and every month after PRF neuromodulation over a 9-month period.
RESULTS
The mean VAS score of 11 patients before PRF was 6.4+/-1.49, and the scores at 6-month and 9 month follow-up were 1.0+/-0.73 and 1.5+/-1.23, respectively. A significant pain reduction (p<0.001) was observed. The mean OSS score of 11 patients before PRF was 22.7+/-8.1, and the scores at 6-month and 9 month follow-up were 41.5+/-6.65 and 41.0+/-6.67, respectively. A significant OSS improvement (p<0.001) was observed.
CONCLUSION
PRF neuromodulation of the suprascapular nerve is an effective treatment for chronic shoulder pain, and the effect was sustained over a relatively long period in patients with medically intractable shoulder pain.

Keyword

Chronic pain; Failed back surgery syndrome; Spinal surgery; Spinal cord stimulation

MeSH Terms

Adhesives
Bursitis
Chronic Pain
Extremities
Failed Back Surgery Syndrome
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Nerve Block
Quality of Life
Rotator Cuff
Shoulder Pain*
Shoulder*
Spinal Cord Stimulation
Ultrasonography
Adhesives

Figure

• 

  Fig. 1 C-arm fluoroscopy image of pulsed radiofrequency neuromodulation showing fluoroscopy landmarks for the suprascapular nerve (asterix), which is located in the suprascapular notch (white curved line) at the midpoint of the scapular spine (white straight line).

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