Using double needle method and passing by L5/S1 internal edge of lumbar facet joint to ablate superior hypogastric plexus for treatment of chronic pelvic pain

Abstract

Objective To evaluate the efficacy and safety of using double needle method and passing by L5/S1 internal edge of lumbar facet joint to destroying superior hypagastric plexus for treatment of chronic pelvic pain. Methods 15 female eases were cho- sen who suffered from chronic pelvic pain caused by endometriosis, and could not liberate from pain with conventional therapy. L5/S1 intervertebral disc and internal edge of lumbar facet joint were identified using fluoroscopy at prone position. The needle was then pene- trated into the disc and advanced under lateral fluoroscopic control. While the needle position was verified correctly, neurolysis was performed with 20 ml of 10% phenol solution. Spending time for the procedure and the analgesic effect was measured and evaluated, respectively. Results The average spending time for the procedure was (26.3±4.6) rain. All patients got significant pain relief im- mediately after the ablation (P<0.05), and daily consumption of analgesics significantly reduced (P<.0.01). Except constipation occurred in one patient, no other complications such as discitis, disc rupture or nerve injury arose. Conclusion Using double needle method and passing by internal edge of lumbar facet joint to ablate superior hypogastric plexus is an easy, safe and effective therapy with less side effect for relieving chronic pelvic pain from endometriosis. Key words: lumbar facet joint ; chronic pelvic pain ; superior hypogastric plexus ; chemical neurolysis ;