팔꿉굴증후군 환자에서 초음파를 이용한 척골신경의 박동성고주파술의 경험 −증례보고−
Ultrasound-guided Pulsed Radiofrequency Lesioning of the Ulnar Nerve in a Patient with Cubital Tunnel Syndrome −A case report−
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Ulnar nerve compression in the cubital tunnel is a common entrapment syndrome of the upper limb. Pulsed radiofrequency lesioning (PRFL) has been reported as a treatment method for relieving neuropathic pain. Since the placement of the electrode in close proximity to a targeted nerve is very important for the success of PRFL, ultrasound seems to be well suited for this technique. A 36-year-old woman presented with complaints of numbness and pain on the medial aspect of the elbow and the pain radiated down to the 4th and 5th fingers for 10 years after she suffered an elbow contusion, we then scheduled this woman for the ultrasound guided PRFL of the ulanr nerve. The initial ultrasound examination demonstrated a swollen nerve, loss of the fascicular pattern and an increased cross sectional area of the ulnar nerve. After confirmation of the most swollen site of the nerve via ultrasound, two sessions of PRFL were performed. The postprocedural 10 cm visual analog scale score decreased from 8 to 1 after the two sessions of PRFL. (Korean J Pain 2008; 21: 224-228)
Abstract
Ulnar nerve compression in the cubital tunnel is a common entrapment syndrome of the upper limb. Pulsed radiofrequency lesioning (PRFL) has been reported as a treatment method for relieving neuropathic pain. Since the placement of the electrode in close proximity to a targeted nerve is very important for the success of PRFL, ultrasound seems to be well suited for this technique. A 36-year-old woman presented with complaints of numbness and pain on the medial aspect of the elbow and the pain radiated down to the 4th and 5th fingers for 10 years after she suffered an elbow contusion, we then scheduled this woman for the ultrasound guided PRFL of the ulanr nerve. The initial ultrasound examination demonstrated a swollen nerve, loss of the fascicular pattern and an increased cross sectional area of the ulnar nerve. After confirmation of the most swollen site of the nerve via ultrasound, two sessions of PRFL were performed. The postprocedural 10 cm visual analog scale score decreased from 8 to 1 after the two sessions of PRFL. (Korean J Pain 2008; 21: 224-228)
참고문헌 (16)
- Stewart JD, "Compression and entrapment neuropathies. In: Peripheral neuropathy. 3rd", pp.1354~9 (2004), Philadelphia, Saunders
- Marhofer P, "Ultrasonographic guidance improves sensory block and onset time of three-in-one blocks", Anesth Analg, 85, pp.854~7 (1997)
- Marhofer P, "Ultrasonographic guidance reduces the amount of local anesthetic for 3-in-1 blocks", Reg Anesth Pain Med, 23, pp.584~8 (1998)
- 문진천, "초음파 유도하에서의 요추부 후관절 내측지 차단술을 위한 주요 척추 구조물의 거리 측정", 대한통증학회지, 20(2), pp.111~115 (2007), 대한통증학회
- Martinoli C, "Ultrasound of nerve entrapments in osteofibrous tunnels of the upper and lower limbs", Radiographics, 20, pp.199~213 (2000)
- Jacobson JA, "Ulnar nerve dislocation and snapping triceps syndrome; diagnosis with dynamic sonography- report of three cases", Radiology, 220, pp.601~5 (2001)
- Draghi F, "Ultrasound of the elbow: examination techniques and US appearance of the normal and pathologic joint", J Ultrasound, 10, pp.76~84 (2007)
- Puig S, "Sonographic diagnosis of recurrent ulnar nerve compression by ganglion cysts", J Ultrasound Med, 18, pp.433~6 (1999)
- Okamoto M, "Diagnostic ultrasonography of the ulnar nerve in cubital tunnel syndrome", J Hand Surg Br, 25, pp.499~502 (2000)
- Chiou HJ, "Cubital tunnel syndrome: diagnosis by high- resolution ultrasonograohy", J Ultrasound Med, 17, pp.643~8 (1998)
- Jacob D, "Sonoanatomy of the ulnar nerve in the cubital tunnel: a multicenter study by the GEL", Eur Radiol, 14, pp.1770~3 (2004)
- Slappendel R, "The efficacy of radiofrequency lesioning of the cervical spinal dorsal root ganglion in a double blind randomized study: no difference between 40 degrees C and 67 degrees C treatments", Pain, 73, pp.159~63 (1997)
- Sluijter ME, "The role of radiofrequency in failed back surgery patients", Curr Rev Pain, 4, pp.49~53 (2000)
- 차영덕, "박동성 고주파열응고술", 대한통증학회지, 17(2), pp.12~12 (2004), 대한통증학회
- Kane TP, "Pulsed radiofrequency applied to the suprascapular nerve in painful cuff tear arthropathy", J Shoulder Elbow Surg, 17, pp.436~40 (2008)
- Kawaguchi M, "Percutaneous radiofrequency lesioning of sensory branches of the obturator and femoral nerves for the treatment of hip joint pain", Reg Anesth Pain Med, 26, pp.576~81 (2001)