Bipolar pulsed radiofrequency neuromodulation of median nerve for treatment of carpal tunnel syndrome – a preliminary study
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Department of Orthopaedics, Sokołowski Memorial Hospital, Wałbrzych, Poland
Department of Epidemiology, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
Department of Biostatistics, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
Department of Neurosurgery, Sokołowski Memorial Hospital, Wałbrzych, Poland
Jerzy Lesław Słowiński   

Zakład Epidemiologii, Katedra Epidemiologii i Biostatystyki, Wydział Nauk o Zdrowiu w Bytomiu, Śląski Uniwersytet Medyczny w Katowicach, ul. Piekarska 18, 41-902 Bytom
Ann. Acad. Med. Siles. 2021;75:107–110
The results of direct surgical release of the median nerve in patients with carpal tunnel syndrome are frequently far from being satisfactory. Aim of the presented study is to assess the early results of bipolar pulsed radiofrequency (PRF) neuromodulation of the median nerve (MN) for treatment of carpal tunnel syndrome (CTS).

Material and methods:
Fifteen adult patients with CTS (10 women and 5 men, mean age 58.5 years) were treated. The bipolar technique of neuromodulation was applied, with confirmation of the correct electrode position by neurophysiological examination. The study protocol included the Boston Carpal Tunnel Questionnaire (BCTQ), Numerical Rating Scale (NRS) for pain assessment and tip pinch strength assessment performed before neuromodulation as well as 4 and 12 weeks after treatment. Moreover, the sensory nerve conduction velocity (SNCV) was assessed before and 12 weeks after the intervention.

A significant improvement in symptom severity (33.53 ± 8.25 at the baseline vs. 18.33 ± 11.06 and 25.67 ± 12.39 at 4 and 12 weeks) and functional status (21.0 ± 5.79 vs. 12.07 ± 7.20 and 17.73 ± 9.09) BCTQ subscores, as well as tip pinch strength (3.39 ± 1.68 vs. 5.86 ± 1.98 and 4.93 ± 2.22) were observed. A reduction in pain and improvement in SNCV were also found, but did not reach statistical significance.

Bipolar PRF neuromodulation of MN is a promising therapeutic tool for patients with CTS and could potentially be an alternative to direct surgical release of MN. A longer follow-up period is required to assess the longevity of clinical improvement after the treatment.

The project was funded by the Medical University of Silesia, Katowice, Poland, grant No. KNW-1-205/N/7/K
None declared
Dec P., Zyluk A. Bilateral carpal tunnel syndrome – A review. Neurol. Neurochir. Pol. 2018; 52(1): 79–83, doi: 10.1016/j.pjnns.2017.09.009.
Kaplan J., Roth C., Melillo A., Koko E., Fuller D., Perry A. Analysis of surgical options for patients with bilateral carpal tunnel syndrome. J. Orthop. 2020; 22: 86–89, doi: 10.1016/j.jor.2020.03.060.
Patijn J., Vallejo R., Janssen M., Huygen F., Lataster A., van Kleef M. et al. Carpal tunnel syndrome. Pain Pract. 2011; 11(3): 297–301, doi: 10.1111/j.1533-2500.2011.00457.x.
Aroori S., Spence R.A. Carpal tunnel syndrome. Ulster Med. J. 2008; 77(1): 6–17.
Belze O., Remerand F., Laulan J., Augustin B., Rion M., Laffon M. et al. Chronic pain after carpal tunnel surgery: epidemiology and associated factors. Ann. Fr. Anesth. Reanim. 2012; 31(12): e269–274, doi: 10.1016/j.annfar.2012.08.009.
Haider N., Mekasha D., Chiravuri S., Wasserman R. Pulsed radiofrequency of the median nerve under ultrasound guidance. Pain Physician 2007; 10(6): 765–770.
Chen L.C., Ho C.W., Sun C.H., Lee J.T., Li T.Y., Shih F.M. et al. Ultrasound-guided pulsed radiofrequency for carpal tunnel syndrome: a single-blinded randomized controlled study. PLoS One 2015; 10(6): e0129918, doi: 10.1371/journal.pone.0129918.
Berger M.L., Dreyer N., Anderson F., Towse A., Sedrakyan A., Normand S.L. Prospective observational studies to assess comparative effectiveness: the ISPOR good research practices task force report. Value Health 2012; 15(2): 217–230, doi: 10.1016/j.jval.2011.12.010.
Padua L., LoMonaco M., Gregori B., Valente E.M., Padua R., Tonali P. Neurophysiological classification and sensitivity in 500 carpal tunnel syndrome hands. Acta Neurol. Scand. 1997; 96(4): 211–217, doi: 10.1111/j.1600-0404.1997.tb00271.x.
Sluijter M.E., Cosman E.R., Rittman W.J., van Kleef M. The effects of pulsed radiofrequency fields applied to the dorsal root ganglion – a preliminary report. Pain Clin. 1998; 11: 109–117.
Facchini G., Spinnato P., Guglielmi G., Albisinni U., Bazzocchi A. A comprehensive review of pulsed radiofrequency in the treatment of pain associated with different spinal conditions. Br. J. Radiol. 2017; 90(1073): 20150406, doi: 10.1259/bjr.20150406.
Sluijter M.E., Imani F. Evolution and mode of action of pulsed radiofrequency. Anesth. Pain Med. 2013; 2(4): 139–141, doi: 10.5812/aapm.10213.
Vanneste T., Van Lantschoot A., Van Boxem K., Van Zundert J. Pulsed radiofrequency in chronic pain. Curr. Opin. Anaesthesiol. 2017; 30(5): 577–582, doi: 10.1097/ACO.0000000000000502.
Chang M.C., Cho Y.W., Ahn S.H. Comparison between bipolar pulsed radiofrequency and monopolar pulsed radiofrequency in chronic lumbosacral radicular pain: A randomized controlled trial. Medicine (Baltimore) 2017; 96(9): e6236, doi: 10.1097/MD.0000000000006236.
Manual of RF techniques – a practical manual of radiofrequency procedures in chronic pain management. 3rd ed. Gauci C.A. [ed.]. CoMedical. Ridderkerk 2011.