Essentials of Radiofrequency Ablation of the Spine and Joints

Foreword
Contents
Contributors
Part I: Foundations of RFA
	Chapter 1: History and Development of Radiofrequency Ablation for Chronic Pain
		References
	Chapter 2: Mechanism of Action of Radiofrequency Ablation
		Why Knowing the Mechanism of Radiofrequency Is Important?
		Review of the Neurological Base of Nerve Injury
		Physics of Radiofrequency
		Different Applications of Radiofrequency
			Thermal
			Pulsed
			Cryoablation
			Mechanism of Action of Radiofrequency
		Ablation Mechanism of Radiofrequency
			Nerve Regeneration and Pain Recurrence
		Non-ablative Mechanisms of Radiofrequency
			Electromagnetic Fields
			Disrupt and Modulate Pain Signal Transmission Via Nerve Fibers
			Microglia Activation
			Gene Expression
			C-Fos
			M-ENK
			TNF-α, IL-6, IL-1
			Calcitonin Gene-Related Peptide
			ATF 3 (Is the Extended PRF Efficient?)
			Neurotransmitter (BDNF, PI3K, and p-ERK)
			Excitatory Amino Acids (EAAs)
			Regenerative Mechanism
			IGF-2
			Cellular and Histological Changes in RA
		Concluding Remarks
		References
	Chapter 3: Types of Radiofrequency Ablation-Pulsed Radiofrequency Ablation
		What Is Pulsed RFA
		Biophysics of Pulsed RFA
		Comparison to Conventional Thermal RFA
		Specific Comparisons of Conventional RF and Pulsed RF Based on Neural Target
		Chronic Pain Targets
		Other Indications for Pulsed RFA
		References
			Recommended Reading
	Chapter 4: Types of Radiofrequency Ablation-Cooled Radiofrequency Ablation
		Introduction
		Mechanism of Cooled RFA
		Chronic Pain Applications of CRFA
			Sacroiliac Joint Pain
			Discogenic Pain
			Facet Joint Pain
			Knee Pain
		Other Applications of Cooled RFA Outside of Chronic Pain
		Reimbursement and Challenges
		References
	Chapter 5: Monopolar Versus Bipolar Radiofrequency Ablation
		References
Part II: Indications for RFA
	Chapter 6: Cervical Spine
		Anatomy
			Vertebrae
			Intervertebral Discs
			Joints
			Nerves
		Conclusion
		Work-up
		Technique
			Diagnostic Block Technique
		Radiofrequency Ablation Technique
		Complications
		References
	Chapter 7: Thoracic Spine
		Anatomy
			Structure and Function
			Clinical Significance
			Conclusion
		Work-Up
			Clinical Presentation
			Diagnostic Laboratory Tests
			Electrodiagnostic Procedures
			Diagnostic Imaging Tests
			Diagnostic Imaging Procedures
		Technique
			Thoracic Medial Branch Blocks: Technique
		Thoracic Medial Branch Radiofrequency Ablation: Technique
		Complications
		References
	Chapter 8: Lumbar Spine
		Anatomy
		Function
		Innervation
		Biomechanics
		Lumbar Pain
			Work-up
			History and Physical Exam
			Imaging
		Lumbar Diagnostic Medial Branch Block and Radiofrequency Ablation Technique
			Positioning
			Diagnostic Lumbar Medial Branch Block (MBB) Technique
			Lumbar Radiofrequency Ablation (RFA) Technique
		Complications
		References
	Chapter 9: Vertebral Body
		Anatomy
		Workup
		Facet Joint Syndrome
		Sacroiliac Joint (SIJ) Pain
		Discogenic Versus Vertebrogenic Pain
		Procedural Technique
		Complications
		References
	Chapter 10: Spinal Metastasis and Spinal Tumors
		Introduction of Percutaneous Ablation of Spinal Neoplastic Disease
		Optimizing the Diagnostic Accuracy of Spinal Metastases
		Management of Metastatic Spine Disease
		Spine Radiofrequency Ablation
		Bone Health in Patients with Cancer
		Treatment Considerations for Pain and Symptom Control
		Stratification of Lesions in the Ablative Treatment of Spinal Metastases
		Treating Patients with Radiofrequency Ablation and Vertebral Augmentation
		Other Thermal Ablation Modalities Used in the Treatment of Spinal Metastases: Microwave Ablation
		Summary and Conclusion
		References
	Chapter 11: Sacroiliac Joint
		Anatomy
		Function
		Bones
			The Sacroiliac Joint
			Cartilage
		Ligaments
			Innervation
		Workup
			History
			Physical Examination
			Radiological Evidence
			Diagnostic Intra-articular Injection
		Procedural Technique
			Introduction
			Background for Sacral Block Technique
			Background for Sacral RFA Technique
			Overview of Sacral Sensory Innervation
			Indications
			Contraindications
			Informed Consent
			Patient Education
			Sedation
			Patient Preparation
			Patient Positioning for Sacral Procedures
			C-Arm Positioning for Sacral Procedures
			C-Arm Positioning
			Description of L5 Dorsal Ramus Block Technique
			Description of Sacral Lateral Branch Block Technique
			Description of L5 RFA
			Description of Sacral Lateral Branch RFA Technique
			Other Techniques
			Considerations of RF Lesion
		Complications
		References
	Chapter 12: Hip
		Anatomy
		Innervation
		Anterior Hip Innervation
			Superolateral and Inferolateral Quadrants
			Superomedial and Inferomedial Quadrants
		Posterior Hip Innervation
			Posteromedial Hip: Sciatic Nerve and the Nerve to the Quadratus Femoris
			Posteromedial Hip: Superior Gluteal Nerve
			Posteroinferior Hip: Inferior Gluteal Nerve or Obturator Nerve
		Anatomic Targets for Hip Radiofrequency Ablation
		Clinical Workup of the Hip-Related Pain Patient
		Diagnostic and Prognostic Workup for Hip Radiofrequency Neurolysis
			Historical Considerations
			Technique
			Hip Joint Denervation: Targets for Ablation
			Preparation
			Step 1: Find Your Best PA Image
			Step 2: Optimizing Visualization of the Obturator Foramen on the Affected Side and Elongating the Ischial Tuberosity
			Step 3: Closing the Distance/Visualizing Your Approach
			Step 4: Anesthetize the Approach
			Step 5: Insertion of Introducer
			Step 6: Placement at Lesioning Site
			Step 7: Probe Insertion
			Step 8: Probe and Introducer Removal
		Fluoroscopic Setup for the Femoral Articular Sensory Branch RFA
			Step 3: Note the Target at the 12 o’clock Position
			Step 4: Optimizing Visualization of the Obturator Foramen on the Affected Side and Observing the Acetabular Ridge at the 12 o’clock Position
			Step 3: Closing the Distance
			Step 4: Determining Your Trajectory, Part I
			Step 5: Determining Your Trajectory, Part II
			Step 6: Anesthetize the Approach/Place the Introducer
			Step 7: Probe Insertion
			Step 8: Probe and Introducer Removal
		Potential Complications
		Long-Term Outcomes
		Complications
		References
	Chapter 13: Knee
		Applied Anatomy
		Workup
		Technique (Diagnostic Block/RFA)
		Potential Complications
		Long-Term Outcomes
		Conclusions and Future Directions
		References
	Chapter 14: Shoulder
		Anatomy
			Innervation
		Etiologies and Associated Pathologies
			Suprascapular Neuropathy
			Glenohumeral Joint and Instability
			Acromioclavicular Joint and Sprain
			Rotator Cuff Complex and Correlative Pathology
			Adhesive Capsulitis
		Workup
			Examination
			Diagnostics
			Treatment
		Technique
			Blockage of the Suprascapular Nerve
			Blockade of the Axillary and Lateral Pectoral Nerve
		Complications
		References
Part III: Other Indications and the Future of RFA
	Chapter 15: Peripheral Nerve Radiofrequency Ablation
		Introduction
		Occipital Nerve Radiofrequency Ablation
			Anatomy
			Workup
			Technique
			Complications
			Long-Term Outcomes
		Intercostal Nerve Radiofrequency Ablation
			Anatomy
			Workup
			Technique
			Complications
			Long-Term Outcomes
		Lateral Femoral Cutaneous Radiofrequency Ablation
			Anatomy
			Workup
			Technique
			Complications
			Long-Term Outcomes
		Ilioinguinal/Iliohypogastric Nerves Radiofrequency Ablation
			Anatomy
			Workup
			Technique
			Complications
			Long-Term Outcomes
		Genitofemoral Nerve Radiofrequency Ablation
			Anatomy
			Workup
			Technique
			Complications
			Long-Term Outcomes
		Sural Nerve Radiofrequency Ablation
			Anatomy
			Workup
			Technique
			Complications
			Long-Term Outcomes
		Medial Calcaneal Nerve Radiofrequency Ablation
			Anatomy
			Workup
			Technique
			Complications
			Long-Term Outcomes
		References
	Chapter 16: Future Indications
		Introduction
		New and Trending Indications of RF in Pain Medicine
			Headache Pain Syndromes
			Facial Pain Syndromes
			Temporomandibular (TMD) Disorders
			Neck and Brachial Plexus Pain Syndromes
			Shoulder Pain Syndromes
			Elbow Pain Syndromes
			Hand and Wrist Pain Syndromes
			Chest Wall Pain Syndromes
			Thoracic Spine Pain Syndromes
			Abdominal and Groin Pain Syndromes
			Lumbar Spine and Sacroiliac Joint Pain Syndromes
			Pelvic and Hip Pain Syndromes
			Lower Extremity Pain Syndromes
			Knee and Distal Lower Extremity Pain Syndromes
			Ankle Pain Syndromes
			Foot Pain Syndromes
			Specific Chronic Pain Syndromes
		Potential Future Indications of RF in Pain Management
		New Techniques and Applications
			Anesthetic and Curved Needle: Author’s Tip
			Low-Temperature Plasma Radiofrequency Ablation
			Computational Analysis of RF in Pain Management
			Peripheral Nerve Injury Ablation
			Reduce Complications of RF
		Conclusion and Future Research
		References
Index