Pulsed radiofrequency of lumbar nerve roots for treatment of chronic inguinal herniorraphy pain.

Abstract

Inguinal hernia repairs are commonly performed and although not seen in a majority of patients, chronic inguinal pain can be a debilitating state resulting after inguinal hernia repairs. Treatment options exist, including pharmacological and surgical management, but with associated risks and side effects. In this case series report, five patients with chronic inguinal pain were selected. After initial positive response to T12, L1 and L2 nerve root blocks, pulse radiofrequency (PRF) was performed. All patients reported 75% to 100% pain relief lasting from six to nine months. Several hypotheses have been proposed, including selective delta and c-nerve fiber destruction, upregulation of intermediate early gene expression (IEG) and increase in c-fos protein that modulated pain transmission. The mechanism of action of pulsed radiofrequency remains unclear. This case study demonstrates the effectiveness of minimally invasive neurodestruction of T12, L1 and L2 nerve roots utilizing Pulse Radiofrequency fields.