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Radiofrequency Neurotomy for a Patient with Deep Brain Stimulators: Proposed Safety Guidelines

Authors


Michael Osborne, MD, Mayo Clinic—Pain Medicine, 4500 San Pablo Rd. Mayo Bld. 5, Jacksonville, FL 32224, USA. Tel: 904-953-2000; Fax: 904-956-3193; E-mail: osborne.michael@mayo.edu.

ABSTRACT

Objective.  To discuss the potential risks inherent to performing radiofrequency procedures in patients with deep brain neurostimulators, and to propose safety guidelines.

Design.  Case report.

Setting.  Tertiary care teaching hospital.

Subject.  A 67-year-old male with intractable back pain due to advanced lumbar spondylosis, with a history of advanced Parkinson's Disease requiring two deep brain stimulators.

Intervention.  Radiofrequency neurotomy lumbar facet joints.

Results.  No atypical symptoms were reported during the procedure that would indicate iatrogenic injury from radiofrequency effect on the deep brain neurostimulators. The subject's back pain was relieved by 70% for greater than 6 months bilaterally.

Discussion.  There are several theoretical concerns when using radiofrequency therapies on patients with neurostimulators. Our patient did not experience any known adverse events during or subsequent to the procedure. This article presents our proposed safety guidelines for using radiofrequency neurotomy on patients with deep brain stimulators.

Conclusions.  Radiofrequency medial branch neurotomy was performed on a patient with two deep brain stimulators with a satisfactory clinical outcome, and no adverse sequelae. Additional study is warranted regarding the safety and compatibility of brain neurostimulators and radiofrequency interventions.

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