Thoracic rhizotomy versus thoracic paravertebral nerve radiofrequency in thoracic cancer pain

Background
Lung cancer is the most frequent occurring malignancy and mostly presenting with pain. Interventional procedures reduce medications and their side effects. Rhizotomy is another modality for control of chest wall pain due to tumor invasion or somatic and neural structures. We compared the degree of pain relief in thoracic rhizotomy versus thoracic paravertebral nerve radiofrequency.
Results
Six hours postoperatively, radiofrequency (RF) ablation of dorsal root ganglia resulted in reduction of required dose of narcotics in 12 patients (80%) compared to 6 patients (40%) treated with RF ablation of TPN ( value = 0.025). After 4 weeks reduction in required narcotic dose was recorded in 80.0% of DRG patients compared to 33.3% of TPN patients ( value = 0.010). Patients’ activity improved in 11 patients (73.3%) in DRG group compared to 5 patients (33.3%) in TPN group ( value = 0.028). No significant difference in frequency of sensory loss ( value = 1.000), burning sensation ( value = 0.128) and allodynia ( value = 0.139).
Conclusion
RF ablation of DRG is superior to RF ablation of TPN in relieving thoracic pain with more improvement of patients’ activity and similar adverse outcomes.