(397) Fluoroscopically-guided radiofrequency neurotomy technique for the treatment of genitofemoral neuralgia

Abstract

Genitofemoral neuralgia (GFN) is a pain syndrome that causes burning, tingling, and numbness along the groin and medial thigh. The etiology is thought to be nerve entrapment or iatrogenic injury. GFN has been noted following surgeries such as inguinal herniorraphy, appendectomy, caesarian section, lymph node biopsy, hysterectomy, vasectomy, and urethral sling surgery. GFN has been treated with medications, surgical neurotomies, and with various ablative interventional procedures. These interventional procedures have been performed blindly, with CT guidance, or with ultrasound guidance. In this article we present the case of a 48-year-old-woman with GFN who responded to anesthetic nerve blockade of the genitofemoral nerve and subsequent fluoroscopically-guided genitofemoral radiofrequency neurotomy. She experienced complete relief of her symptoms immediately post-procedure and had 95% pain relief at 1.5 month-follow-up. To the knowledge of the authors, this is the first technical description of a fluoroscopic guidance technique for genitofemoral neurotomy.