Ultrasound-Assisted Pulsed Radiofrequency Targeting the Dorsal Root Ganglion for Intractable Postherpetic Neuralgia with Lumbar Radicular Pain

Abstract

Aims: We report the successful use of ultrasound-assisted pulsed radiofrequency (RF) treatment of the L2 dorsal root ganglion (DRG) for intractable post-herpetic neuralgia (PHN) with lumbar radicular pain, wherein ultrasound-guided pulsed RF targeting of the lumbar DRG was effective in providing satisfactory pain relief. Case Presentation: An 86-year-old man suffering from intractable PHN for over a year was referred to our pain clinic. The chronic pain radiated into the superior medial thigh of the right leg ever since the onset of herpes zoster. Physical examination revealed dynamic allodynia with scarred skin on the right medial thigh. In spite of repeat epidural blocks, the duration of therapeutic effect was not prolonged. Therefore, we decided to attempt ultrasound-assisted RF treatment of the L2 DRG for intractable PHN with lumbar radicular pain. Ultrasound-guided pulsed RF targeting of the lumbar DRG provided satisfactory pain relief. Following the procedure, the visual analogue pain score decreased from 7 to 1 and remained constant even after 6 months. Conclusion: Pain physicians should consider pulsed RF for lumbar DRG since this method appears to offer long-lasting therapeutic effects for intractable PHN with lumbar radicular pain.