Ultrasound-guided pulsed radiofrequency neuromodulation of the suprascapular nerve in partial rotator cuff tears
Ultrasound-guided pulsed radiofrequency neuromodulation of the suprascapular nerve in partial rotator cuff tears
Background/Aim: Pulsed radiofrequency (PRF) of the suprascapular nerve has been shown to be effective in the treatment of chronicshoulder pain. Ultrasound (US) guidance has gained popularity in regional blocks recently. This study aims to investigate the efficacy ofsuprascapular nerve pulsed radiofrequency under the guidance of ultrasonography.Materials and methods: This retrospective study included patients treated with PRF of the suprascapular nerve with a diagnosis ofpartial rotator cuff tears. The patients were assessed with a numeric rating scale (NRS), the Shoulder Pain and Disability Index (SPADI),and a Likert patient satisfaction score before the treatment and 3 weeks and 6 months following the treatment.Results: A total of 31 patients was included in the study. The patients’ mean age was 66.8 ± 13.3 years. The mean scores of the NRS,SPADI, and Likert scale before the procedure (7.32 ± 1.1, 69.0 ± 8.5, 1.6 ± 0.6) and at 3 weeks (2.9 ± 2.1, 32.1 ± 17.20, 4 ± 1.2) and 6months (3.2 ± 2.6, 33.9 ± 20.8, 3.8 ± 1.2) after the procedure were evaluated. We observed significant improvement in NRS, SPADI, andLikert scores at 3 weeks and 6 months following the treatment (P < 0.001).Conclusion: The study demonstrated that US-guided suprascapular nerve PRF achieves good pain relief and functional improvementin patients with partial rotator cuff tears for at least 6 months.
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- 1. Jang JS, Choi HJ, Kang SH, Yang JS, Lee JJ et al. Effect of pulsed
radiofrequency neuromodulation on clinical improvements in
the patients of chronic intractable shoulder pain. Journal of
the Korean Neurosurgical Society 2013; 54 (6): 507-510. doi:
10.3340/jkns.2013.54.6.507
- 2. Dahan TH, Fortin L, Pelletier M, Petit M, Vadeboncoeur R
et al. Double blind randomized clinical trial examining the
efficacy of bupivacaine suprascapular nerve blocks in frozen
shoulder. Journal of Rheumatology 2000; 27 (6): 1464-1469.
- 3. Gofeld M, Restrepo-Garces CE, Theodore BR, Faclier G. Pulsed
radiofrequency of suprascapular nerve for chronic shoulder
pain: a randomized double-blind active placebo-controlled
study. Pain Practice 2013; 13 (2): 96-103. doi: 10.1111/j.1533-
2500.2012.00560.x
- 4. Munglani R. The longer term effect of pulsed radiofrequency for
neuropathic pain. Pain 1999; 80 (1-2): 437-439. doi: 10.1016/
s0304-3959(98)00183-3
- 5. Rohof OJJM. Radiofrequency treatment of peripheral nerves.
Pain Practice 2002; 2 (3): 257-260. doi: 10.1046/j.1533-
2500.2002.02033.x
- 6. Peng PWH, Wiley MJ, Liang J, Bellingham GA. Ultrasoundguided suprascapular nerve block: a correlation with fluoroscopic
and cadaveric findings. Canadian Journal of Anaesthesia 2010;
57 (2): 143-148. doi: 10.1007/s12630-009-9234-3
- 7. Taskaynatan MA, Ozgul A, Aydemir K, Koroglu OO, Tan AK.
Accuracy of ultrasound-guided suprascapular nerve block
measured with neurostimulation. Rheumatology International
2012; 32 (7): 2125-2128. doi: 10.1007/s00296-011-1948-1
- 8. Ergonenc T, Beyaz SG. Effects of ultrasound-guided
suprascapular nerve pulsed radiofrequency on chronic
shoulder pain. Medical Ultrasonography 2018; 20 (4): 461-466.
doi: 10.11152/mu-1543
- 9. Shah RV, Racz GB. Pulsed mode radiofrequency lesioning of
the suprascapular nerve for the treatment of chronic shoulder
pain. Pain Physician 2003; 6 (4): 503-506.
- 10. Vanneste T, Van Lantschoot A, Van Boxem K, Van Zundert
J. Pulsed radiofrequency in chronic pain. Current Opinion
in Anaesthesiology 2017; 30 (5): 577-582. doi: 10.1097/
ACO.0000000000000502
- 11. Bicer A, Ankarali H. Shoulder pain and disability index: a
validation study in Turkish women. Singapore Medical Journal
2010; 51 (11): 865-870.
- 12. Vorster W, Lange CPE, Briët RJP, Labuschagne BCJ, Toit du
DF et al. The sensory branch distribution of the suprascapular
nerve: an anatomic study. Journal of Shoulder and Elbow
Surgery 2008; 17 (3): 500-502. doi: 10.1016/j.jse.2007.10.008
- 13. Ritchie ED, Tong D, Chung F, Norris AM, Miniaci A et al.
Suprascapular nerve block for postoperative pain relief in
arthroscopic shoulder surgery: a new modality? Anesthesia
& Analgesia 1997; 84 (6): 1306-1312. doi: 10.1097/00000539-
199706000-00024
- 14. Wu YT, Ho CW, Chen YL, Li TY, Lee KC et al. Ultrasoundguided pulsed radiofrequency stimulation of the suprascapular
nerve for adhesive capsulitis: a prospective, randomized,
controlled trial. Anesthesia & Analgesia 2014; 119 (3) 686-692.
doi: 10.1213/ANE.0000000000000354
- 15. Huang CC, Tsao SL, Cheng CY, Hsin MT, Chen CM. Treating
frozen shoulder with ultrasound-guided pulsed mode
radiofrequency lesioning of the suprascapular nerve: two cases.
Pain Medicine 2010; 11 (12): 1837-1840. doi: 10.1111/j.1526-
4637.2010.00970.x
- 16. Vecchio PC, Adebajo AO, Hazleman BL. Suprascapular
nerve block for persistent rotator cuff lesions. Journal of
Rheumatology 1993; 20 (3): 453-455.
- 17. Erdine S, Bilir A, Cosman ER, Cosman ER Jr. Ultrastructural
changes in axons following exposure to pulsed radiofrequency
fields. Pain Practice 2009; 9 (6): 407-417. doi: 10.1111/j.1533-
2500.2009.00317.x
- 18. Richebé P, Rathmell JP, Brennan TJ. Immediate early genes
after pulsed radiofrequency treatment: neurobiology in
need of clinical trials. Anesthesiology 2005; 102 (1): 1-3. doi:
10.1097/00000542-200501000-00002
- 19. Higuchi Y, Nashold BS, Sluijter M, Cosman E, Pearlstein
RD. Exposure of the dorsal root ganglion in rats to pulsed
radiofrequency currents activates dorsal horn lamina I
and II neurons. Neurosurgery 2002; 50 (4): 850-856. doi:
10.1097/00006123-200204000-00030
- 20. Neal JM, McDonald SB, Larkin KL, Polissar NL. Suprascapular
nerve block prolongs analgesia after nonarthroscopic shoulder
surgery but does not improve outcome. Anesthesia & Analgesia
2003; 96 (4): 982-986. doi: 10.1213/01.ane.0000052380.69541.
d4
- 21. Gurbet A, Türker G, Bozkurt M, Keskin E, Uçkunkaya N et
al. Efficacy of pulsed mode radiofrequency lesioning of the
suprascapular nerve in chronic shoulder pain secondary to
rotator cuff rupture. Ağrı 2005; 17 (3): 48-52 (in Turkish with
English abstract).
- 22. Kane TPC, Rogers P, Hazelgrove J, Wimsey S, Harper GD.
Pulsed radiofrequency applied to the suprascapular nerve in
painful cuff tear arthropathy. Journal of Shoulder and Elbow
Surgery 2008; 17 (3): 436-440. doi: 10.1016/j.jse.2007.10.007
- 23. Sir E, Eksert S, Emin Ince M, Simsek F, Ozkan G et al. A novel
technique: ultrasound-guided serratus anterior plane block for
the treatment of post-traumatic intercostal neuralgia. A case
report. American Journal of Physical Medicine & Rehabilitation
(in press). doi: 10.1097/PHM.0000000000001121
- 24. Perlas A, Lobo G, Lo N, Brull R, Chan VWS et al. Ultrasoundguided supraclavicular block: outcome of 510 consecutive
cases. Regional Anesthesia and Pain Medicine 2009; 34 (2):
171-176. doi: 10.1097/AAP.0b013e31819a3f81
- 25. Sites BD, Antonakakis JG. Ultrasound guidance in regional
anesthesia: state of the art review through challenging clinical
scenarios. Local Regional Anesthesia 2009; 2: 1-14.
- 26. Esparza-Miñana JM, Mazzinari G. Adaptation of an
ultrasound-guided technique for pulsed radiofrequency on
axillary and suprascapular nerves in the treatment of shoulder
pain. Pain Medicine (in press). doi: 10.1093/pm/pny311