Presented at the 2012 AAPM Annual Meeting « Back

Radiofrequency Neurolysis Versus Local Nerve Infiltrations in 41 Patients with Refractory Chronic Inguinal Neuralgia

Adrian Kastler, MD, tomasi@noos.fr¹, Sébastien Aubry, MD PhD², Véronique Piccand, MD³, Florence Tiberghien, MD⁴, Bruno Kastler, MD PhD², (1) Radiology, Clermont Ferrand, Auvergne, France, (2) Interventional Pain Managment Unit, Besancon, Doubs, France, (3) Medecine, Besancon, Doubs, France, (4) CETD CHu jean Minjoz, Besancon, Doubs, France

Purpose: To retrospectively assess and compare the effectiveness and feasibility of radiofrequency neurolysis (RFN) versus local nerve infiltration (LNI) in the management of chronic Inguinal Neuralgia involving ilioinguinal and iliohypogastric nerves. Methods and Material: Forty-one patients suffering from chronic inguinal pain refractory to specific medication were included. Pain was assessed in both groups using Visual Analogue Scale scores measured immediately before and after procedure and at 1-, 3-, 6-, 9-, and 12-month examinations. All procedures were realized ambulatory under CT guidance. LNI was realized with injection of Cortisone/Lidocaine-Naropin. RFN was performed using a Neurotherm RF Generator. Results: A total of 41 patients were included in our study—13 in the RFN group and 28 in the local nerve infiltration (LNI) group. Seventeen RFN were performed and 28 LNI. Forty patients (97.5%) presented post-surgical inguinal pain. Mean VAS scores before procedure were, respectively, 7.76 and 7.46 in the RF group and Infiltration group. Mean duration of pain relief was statistically significant (p=006) in the RF group (12.5 months) compared to the Infiltration Group (1.2 months). Each mean VAS score at 1, 3, 6, 9, and 12 months were significantly inferior in the RF group compared to the infiltration group. Conclusion: Radiofrequency neurolysis is significantly more effective than local infiltrations. It is a safe and effective treatment of chronic inguinal pain. Local steroid injection along with local injection of anesthetics should be used to confirm diagnosis of ilioinguinal neuropathy before RFN.

Funding: None