An Initial Study Of Puncture Approach Of Radiofrequency Ablation For Thoracic Dorsal Root Ganglion

Objective: To analyze the success rate of radiofrequency ablation forthoracic dorsal root ganglion (DRG) with different puncture approach. Todetermine the best puncture approach for radiofrequency ablation in differenttypes thoracic DRG.Methods: Fourteen thoracic spine specimens were randomly dividedinto three groups (Group A: n=2, with a simple trans-foraminal punctureapproach; Group B: n=6, with the single puncture approach; Group C: n=6,with the dual puncture approaches). Each of groups was further divided intothree subgroup including the extra-foraminal type, intra-foraminal type, andspinal canal type according to the different types of DRG. After DRGpuncture were performed under CT-guided, radiofrequency ablation wasexecuted. The success rates of radiofrequency ablation for DRG with differentpuncture approach were analyzed.Results: In group A, the mean success rate of radiofrequency ablationfor different subgroup including extraforaminal type (included29DRG),intraforaminal type (included12DRG) and spinal canal type (included7DRG) was72.58±18.88%;54.16±24.84%;32.85±28.11%, respectively,P<0.05. In Group B, the mean success rate of extraforaminal type with lateralapproach of facet joint (included43DRG) and with transforaminal approach(included45DRG) was71.86±15.15%,72.02±17.86%, respectively; themean damage rate of intraforaminal type with transforaminal approach(included14DRG) and with translaminar notch approach (included16DRG)was57.14±18.02%,52.47±20.64%respectively; the mean damage rate of spinal canal type (included12DRG) with medial approach of facet joint(included14DRG) was68.75±14.63%,71.78±16.00%, respectively. Therewas a significant difference of the mean success rate for DRG radiofrequencyablation among three different DRG type in Group B (P<0.05). In group C,the mean success rate of extra-foraminal type subgroup (included69DRG)with combined lateral approach of facet joint with transforaminal approachwas82.46±14.10%; the mean success rate of intraforaminal type (included39DRG) with combined translaminar notch approach with transforaminalapproach was81.53±11.81%; the mean success rate of spinal canal type(included36DRG) with translaminar notch approach and medial approach offacet joint was80.83±13.33%. There was significant difference of successrates for DRG radiofrequency ablation in differnt type DRG between group Aand C, group B and C (P<0.05).Conclusion: The simple DRG puncture approach has played animportant role in poor efficacy for thoracic DRG radiofrequency ablation. Thesuccess rate of thoracic DRG radiofrequency ablation has been improvedthrough the combined puncture approach according to the different DRGtypes.