stressedout, I agree with your call. And from what I understand, the upside is somewhat lower and the downside is far worse for folks with lower extremity pain, requiring a lumbar procedure.*

To get a picture of the possible downside, I would check out just one article written by an avowed supporter of the precedure, Laxmaiah Manchikanti, MD, "The role of radiofrequency in the management of complex regional pain syndrome," Curr Rev Pain 2000;4(6):437-44, free full text at http://www.rsds.org/2/library/articl...anchikanti.pdf

Pain Management Center of Paducah, 2831 Lone Oak Road, Paducah, KY 42003, USA.

The nomenclature, pathophysiology, and treatment modalities of complex regional pain syndrome (CRPS) are controversial. Thus far there are no specific, scientifically valid treatments for the management of CRPS. The numerous modalities of treatment range from sympathetic ganglion blocks, intravenous regional blocks, administration of a multitude of pharmacologic agents and behavioral interventions, to surgical sympathectomy. Minimally invasive radiofrequency lesioning for managing CRPS is a modality in its developmental stages. This article describes radiofrequency lesioning techniques in managing CRPS. [Emphasis added.]

PMID: 11060589 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum

While even the abstract sounds out of date compared to a few other things that were being published that year (say, Schwartzman RJ, "New Treatments for Reflex Sympathetic Dystrophy," NEJM 2000:654-655, free full text at http://www.rsds.org/2/library/articl...tzman_nejm.pdf) the kicker is when Dr. Manchikanti discusses "Complications of Radiofrequency" at page 442, and in particular, those mentioned in Sub-Paragraph 5 - which I understand to arise primarily from lumbar procedures for lower extremity pain - including "spinal cord infarctions . . . paraplegia . . . that may develop secondary to inadvertant lesioning of the spinal cord or its constituants." Please, scroll down to p. 442 and check them out: http://www.rsds.org/2/library/articl...anchikanti.pdf

Swatgen27, were any of these potential complications disclosed to you?

And is it any wonder, when physicians of the relatively conservative Division of Pain Medicine, Mayo Clinic (Rochester and Jacksonville) published "Complex Regional Pain Syndrome," R.H. Rho, R.P. Brewer, T.J. Lamer, and P.R. Wilson, Mayo Clin Proc. 2002;77:174-180, free full text at http://www.mayoclinicproceedings.com...2/174.full.pdf, that no mention was made the use of Radiofrequency ablation?

Radiofrequency ablation is a blast from the past, and that's where it should stay.

Mike

*On this, check out "Interventional Therapies," Allen W. Burton, MD, in the RSDSA's Complex Regional Pain Syndrome: Treatment Guidelines, R. Norman Harden, MD, editor (2006) http://www.rsds.org/3/clinical_guidelines/:

Wilkinson43 reports the largest series of percutaneous Radio Frequency (RF) lesioning of the thoracic T-2 distribution sympathetic outflow (RF sympathectomy), with over 350 procedures performed with 86% signs of sustained sympathectomy at 3-year follow-up, without any assessment of clinical analgesic or functional outcomes (level 3 evidence for interruption of sympathetic activity in a prolonged fashion with RF techniques).43 Wilkinson reports difficulty with lumbar percutaneous RF techniques due to variability of the lumbar anatomy versus the thoracic ganglion. He also reports a low rate of postprocedure neuralgic syndromes (around 5%), although this is recorded in an unpublished data format within a book chapter.42 This author could find no published data yet on pulsed RF sympathetic ganglion techniques. [Emphasis added.]

Footnotes
42. Kim K, DeSalles A, Johnson J, Ahn S. Sympathectomy: open and thoracoscopic. In: Burchiel K, ed. Surgical Management of Pain. New York, NY: Thieme Publishers; 2002:688-700.
43. Wilkinson H. Percutaneous radiofrequency upper thoracic sympathectomy. Neurosurgery. 1996;38:715-725.

http://www.rsds.org/3/clinical_guide...rventional.pdf