Pulsed radiofrequency neuromodulation for the treatment of saphenous neuralgia

Abstract

A 65-year-old male presented with pain in his right medial calf. An imaging study revealed no acute lesions, and a diagnosis of saphenous neuralgia was made by a nerve conduction study. He received temporary pain relief with saphenous nerve blocks twice in a one-week interval. Pulsed radiofrequency neuromodulation reduced pain to 10% of the maximal pain intensity. At 6 months after the procedure, the pain intensity was not aggravated even without medication. Pulsed radiofrequency neuromodulation of the saphenous nerve may offer an effective and minimally invasive treatment for patients with saphenous neuralgia who are refractory to conservative management.

Keywords: Neuromodulation; Pulsed radiofrequency; Saphenous neuralgia.

Fig. 1

The entry points (red arrows) of the radiofrequency needle inserted to block the saphenous nerve (red free line) are illustrated on the right leg. The right side was positioned with a hip external rotation, a hip abduction, and a knee flexion.

Fig. 2

A : The radiofrequency needle and electrode were applied for the saphenous nerve (red free line) around adductor's canal. B : A lateral radiograph showing the entry point of the radiofrequency needle inserted to block the saphenous nerve above the epicondyle under the inguinal ligament. C : The radiofrequency needle and electrode were applied for the sartorial branch of the saphenous nerve (red free line) around superficial saphenous vein.