- Visto: 348
Investigación
Neurotomía por radiofrecuencia como estrategia de control del dolor crónico relacionado con osteoartrosis: síntesis de técnicas y resumen de la evidencia
Radiofrecuency neurotomy for osteoarthritis pain: technical synthesis and evidence summary
Edición XIII Setiembre - Diciembre 2019
DOI: https://doi.org/10.55139/ATCY2170
Dr. Gabriel Varvajal Valdy
Centro de Manejo del Dolor y Soporte Integral, Hospital Clínica Bíblica, Torre Médica Omega, Piso 6. San José, Costa Rica.
Miembro del Colegio de Médicos y Cirujanos de Costa Rica.
Costa Rica.
Dr. Roberto Rodríguez Miranda
Centro de Manejo del Dolor y Soporte Integral, Hospital Clínica Bíblica, Torre Médica Omega, Piso 6. San José, Costa Rica.
Miembro del Colegio de Médicos y Cirujanos de Costa Rica.
Costa Rica.
Dr. Rodrigo Benavides Cordero
Centro de Manejo del Dolor y Soporte Integral, Hospital Clínica Bíblica, Torre Médica Omega, Piso 6. San José, Costa Rica.
Miembro del Colegio de Médicos y Cirujanos de Costa Rica.
Costa Rica.
Dr. Marco Ferrandino Carballo
Centro de Manejo del Dolor y Soporte Integral, Hospital Clínica Bíblica, Torre Médica Omega, Piso 6. San José, Costa Rica.
Miembro del Colegio de Médicos y Cirujanos de Costa Rica.
Costa Rica.
Resumen
La osteoartrosis es una causa frecuente de dolor crónico, particularmente, en la población de más de cuarenta años. El manejo de este síndrome doloroso es complejo y aún, hoy en día, existen limitadas alternativas de tratamiento analgésico no invasivo basadas en evidencia. La ablación por radiofrecuencia es una técnica percutánea utilizada para tratar, mediante energía eléctrica y térmica, un nervio o un grupo de nervios, con el fin de permitir mejor control del dolor, mejoría funcional y, como variables secundarias, reducción del consumo de analgésicos por vía sistémica. Este conjunto de técnicas permite ofrecer alivio del dolor crónico en la distribución sensitiva de dichos nervios y se han descrito abordajes específicos para tratar condiciones dolorosas crónicas asociadas a la osteoartrosis en distintas áreas anatómicas, tales como cadera, rodilla, hombro y columna. Esta revisión bibliográfica pretende ilustrar las principales técnicas de ablación por radiofrecuencia relacionadas con el tratamiento del dolor producido por la osteoartrosis en sitios anatómicos de alta prevalencia.
Palabras claves
Dolor crónico, osteoartrosis, neurotomía, ablación por radiofrecuencia, tratamiento intervencionista del dolor, medicina paliativa, medicina del dolor.
Abstract
Osteoarthritis is a frequent cause of chronic pain, particularly in the population over forty years of age. Management of this painful syndrome is complex and even today there are limited alternatives of non-invasive evidence-based analgesic treatments. Radiofrequency ablation is a percutaneous technique used to treat a nerve or a group of nerves using electrical and thermal energy, in order to allow better pain control, functional improvement and, as secondary variables, reduction of systemic analgesics. This set of techniques allows chronic pain relief in the sensory distribution of nerves and specific approaches have been described to treat chronic painful conditions associated with osteoarthritis in different anatomical areas such as hip, knee, shoulder and spine. This review aims to illustrate the main techniques of radiofrequency ablation related to the treatment of pain produced by osteoarthritis in high prevalence anatomical sites.
Keywords
Chronic pain, osteoarthritis, neurotomy, radiofrequency ablation, interventional pain management, palliative medicine, pain medicine.
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