Can RSD/CRPS Patients Experience Long Term Pain Relief From PRGR?

RSD/CRPS produces true chronic pain in patients that exceeds all scales of pain measurement and results in some very unique physical changes to their body.

The true chronic pain found in RSD/CRPS patients has had a pathology that has been partially healed, but is causing continuous pain  and invasive operations only add new sources of pain in these patients. However, advances made on researching nerve pain resolution may hold promise for RSD/CRPS patients in the future.

The Department of Neurological Surgery, Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota undertook a study to determine the short term and long term capabilities of PRGR to alleviate chronic nerve pain in patients suffering from extreme medical conditions. The physicians objective was to seek rapid and long lasting pain relief in the  management of trigeminal neuralgia (TN) and  Percutaneous retrogasserian glycerol rhizotomy (PRGR) offers distinct advantages over other available procedures.

The PRGR procedures were performed at the University of Pittsburgh in 2004 on 1174 patients with immediate or early complete pain relief occurring in 90% of patients. An initial report in which 112 patients were evaluated demonstrated 90% pain relief at 2 years, with 60% of this group attaining complete relief after PRGR alone and 23% requiring some additional albeit reduced drug therapy. A subsequent analysis of 376 patients with follow-up durations of up to 7 years found a long-term pain control rate of 85%.5 Sixty percent attained complete relief after glycerol rhizotomy alone, although in some patients repeated procedures were necessary. In a longer-term assessment continuing up to 11 years, investigators found long-lasting relief of pain in 77% of patients, with 55% discontinuing all medications and 22% requiring some drug usage.

In the management of the TN patients, their goals were rapid and long lasting pain relief, together with preservation of trigeminal nerve function. The PRGR technique offers distinct advantages over other percutaneous procedures. These include eliminating the need for intraoperative confirmatory sensory testing (patient cooperation is not necessary) or a radiofrequency generator. The patient simply need not “participate” during the procedure and thus can be more deeply anesthetized. Precise anatomical localization of the target is performed using intraoperative cisternography rather than asking the patient to describe radiofrequency-induced sensory changes. Glycerol is associated with a lower risk of facial sensory loss compared with either radiofrequency rhizotomy or balloon microcompression. This feature significantly reduces the risk of deafferentation pain. They believe that pain relief without significant sensory loss and without high surgical risk is possible for virtually all patients by using MVD, PRGR, or stereotactic radiosurgery, either alone or in combination. The choice of procedure is related to the factors of patient age, medical condition, symptom severity, and personal preference.

Their finding was that PRGR is an effective, low-morbidity surgical procedure in the management of true chronic nerve pain and is associated with prolonged efficacy. Now the question is can this procedure produce similar results for RSD/CRPS patients in managing their nerve pain and when will some research be undertaken to pursue  an answer to that question?

Reference Articles: Medscape Today; Mayo Clinic; ncbi

About Belt Law Firm, P.C.

Belt Law Firm, P.C., is an Alabama law firm with extensive national experience in representing RSD/CRPS afflicted persons and handling RSD/CRPS cases with a focus on regional litigation in Alabama, Tennessee, Georgia, Florida, Arkansas, Mississippi, Texas, New Mexico, Colorado and Delaware. To learn more, call the firm toll-free at 205-933-1500 or use its online form.

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About Belt Law Firm

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The personal injury attorneys at Belt Law Firm have successfully represented RSD/CRPS clients in Alabama, Florida, Georgia, and Tennessee. These cases involved injuries from automobile accidents (shoulder injury, ankle fracture), product malfunctions (hand crush, wrist fracture), slip and falls (knee contusion, wrist fracture), poorly performed blood draws (antecubital pain), and crush injuries (ankle, Achilles tendon).

Among the settlements we have achieved in RSD/CRPS cases are: $2,500,000 for a (AL) slip and fall case involving a woman who developed RSD after suffering a broken wrist, $1,300,000 for a (FL) case where a woman developed RSD after an improperly performed blood draw, and $800,000 for a (TN) woman who developed RSD after suffering a bruised knee due to a slip and fall in a grocery store. ...Read More

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