Radiofrequency neurotomy for the treatment of chronic pain: interference with implantable medical devices.

Abstract

Radiofrequency is widely used in the treatment of chronic pain for its efficacy and low incidence of side effects and complications. Despite this, it is commonly believed that this kind of treatment could interfere with medical implantable devices. Potential interference between implanted devices such as pacemakers, defibrillators and spinal cord stimulators and the radiofrequency of neurotomy is an important concern for physicians caring for patients with these devices. A retrospective study was conducted on 30 radiofrequency-treated patients, collected in five years out of more than 1,000 patients treated. Our cohort was selected due to the presence of implanted medical devices. Treatments include the radiofrequency neurotomy of the lumbar facet joints, intervertebral discs, sacroiliac joint and peripheral nerves. Out of 30 patients and 68 treatments, global radiofrequency ablation was considered safe, due to the absence of any problem during or after the procedure. In particular, procedures were never interrupted because of electrical interference with the implanted devices or for problems attributable to an aberrant activation of them. Neurological and physical exam did not show any alteration after the procedure. There are several theoretical concerns about radiofrequency treatments in patients with implantable electrical medical devices. However, there is no experimental evidence of electrical interference with the implanted devices. Our long experience strongly suggests that by following simple precautions, patients can benefit from radiofrequency pain-relieving procedures without any adverse events.