电刺激治疗术后截瘫--培训课件.ppt

PULSED RF: ADVANTAGES The PRF procedures are not neuro destructive nor do they produce temporary sensory deficit It can be used in neuropathic pain Less discomfort after the procedure Can be used where conventional RF is “forbidden” CASE I General data Sex : male Age : 52 years Chief complain : Severe low back pain with soreness with bilateral lower limbs weakness for years and accepted surgical intervention in 2003 , February. But the symptom persistently existed after surgery. Case number Initial outcome ( improved rate ) 3 months F/U 6 months F/U Chronic low back pain ( lumbar facet syndrome discogenic pain ) 40 36 (90%) 23 (56%) 20 (40%) Failed back syndrome 22 18 (82%) 10 (45%) 6 (27%) Results of Pulsed Radiofrequency:　2003/01/01 - 2003/12/31. Conclusion（1）: The pulsed radiofrequency can apply to functional nerve , highly selective block C fiber long term duration and preserve motor fiber. An effective , safety and minimal invasive therapy to patients who suffered intractable spinal and neuropathic pain including FBSS. Conclusion（2） Chronic lumbar spinal pain ( with surgery) Post surgery with neural injury Post surgery Fail back syndrome Pulsed radiofrequency MRI Neural compression No neural compression surgery Poor response Pulsed radiofrequency Pulsed radiofrequency surgery With radiculopathy Without radiculopathy NCV / EMG Pulsed radiofrequency L2 pulsed radifrequency No response R/o discogenic pain Pulsed radiofrequency IDET Without radiculopathy With radiculopathy NCV / EMG Pulsed radiofrequency L2 Pulsed radiofrequency IDET NVC / EMG FBSS (Failed Back Surgery Syndrome) Without radiculopathy surgery With radiculopathy L2 Pulsed radiofrequency Epidural Injection Procedure Neural compression Re-open surgery Imaging Studies Pulsed radiofrequency Sympathetic Block Imaging Studies IDET (Discogram) Facet Denervation NCV / EMG Mapping Pulsed radiofrequency IDET Spinal Cord Stimulation Post Multi-operation De