16 results on '"Brinkhuizen, T"'
Search Results
2. Support for the hypoxia theory in the pathogenesis of infantile haemangioma
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Janmohamed, S. R., Brinkhuizen, T., den Hollander, J. C., Madern, G. C., de Laat, P. C., van Steensel, M. A., and Oranje, A. P.
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- 2015
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3. Absence of the Birt–Hogg–Dubé gene product is associated with increased hypoxia-inducible factor transcriptional activity and a loss of metabolic flexibility
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Preston, R S, Philp, A, Claessens, T, Gijezen, L, Dydensborg, A B, Dunlop, E A, Harper, K T, Brinkhuizen, T, Menko, F H, Davies, D M, Land, S C, Pause, A, Baar, K, van Steensel, M A M, and Tee, A R
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- 2011
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4. The additional diagnostic value of optical coherence tomography in clinically diagnosed basal cell carcinomas undergoing direct surgical excision.
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Adan, F., Nelemans, P.J., Kelleners‐Smeets, N.W.J., Kessels, J.P.H.M., Brinkhuizen, T., and Mosterd, K.
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BASAL cell carcinoma ,OPTICAL coherence tomography ,SURGICAL excision ,DIAGNOSIS ,SKIN cancer - Abstract
In another prospective study, the PPV of an OCT diagnosis that was made with high confidence was only 80%, but the BCC prevalence in that study was also lower (58-2%) than in the present study (95-6%). Dear Editor, Clinical examination appears to be very sensitive for diagnosing basal cell carcinoma (BCC) (90%), but the specificity is reported to be low (28-6-48-9%).1,2 Additional use of dermoscopy can increase specificity to 54-3-55-6% compared with clinical examination alone.1,2 With use of optical coherence tomography (OCT), a noninvasive diagnostic method, in addition to clinical and dermoscopic examination, it is possible to further increase the specificity to 76% at a sensitivity of 95%.1,3,4 These results apply to a population of patients with a clinical suspicion of BCC who had an indication for biopsy (e.g. high-risk location or uncertainty about diagnosis). Before surgery, an OCT scan was obtained for study purposes and the OCT diagnosis did not influence the treatment decision. [Extracted from the article]
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- 2021
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5. Appearance-related psychosocial distress after facial non-melanoma skin cancer surgery: A 1-year prospective study.
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D'Hondt V, Veldhuizen IJ, Theelen FFM, Herlaar S, Lee EH, Houterman S, Brinkhuizen T, and Hoogbergen MM
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- Humans, Prospective Studies, Mohs Surgery psychology, Face pathology, Face surgery, Surveys and Questionnaires, Skin Neoplasms surgery, Skin Neoplasms psychology
- Abstract
Objective: Patients undergoing Mohs Micrographic Surgery (MMS) for facial non-melanoma skin cancer (NMSC) experience appearance-related psychosocial distress due to its post-surgical esthetic changes. However, little is known about its development over a longer follow-up period. This study prospectively assessed appearance-related psychosocial distress in patients undergoing MMS for facial NMSC over a 1-year follow up period., Methods: Patients who had MMS for facial NMSC between September 2020 and October 2021 were invited to answer the FACE-Q Skin Cancer - appearance-related psychosocial distress scale preoperatively, 2 weeks, 6 months, and 1 year after surgery., Results: A total of 217 patients completed the questionnaire at baseline. In addition, 158 (72.8%), 139 (64.1%), and 120 (55.3%) questionnaires were successfully answered 2 weeks, 6 months, and 1 year after surgery, respectively. Patients with a peripheral lesion presented higher appearance-related psychosocial distress scores at baseline than patients with a central lesion (p = 0.02). There was a decreasing trend in appearance-related psychosocial distress over time, but without a significant result (baseline-2-week; p = 0.73, 2-week-6-month; p = 0.80, 6-month-1-year; p = 0.17, baseline-1-year; p = 0.23). Patients with secondary intention healing and graft reconstruction methods experienced more appearance-related psychosocial distress over time than patients with primary wound closures (p = 0.03)., Conclusions: Patients still experience appearance-related psychosocial distress 1 year after MMS. These patients may benefit from targeted counseling. Additionally, predictors of more appearance-related psychosocial distress, such as secondary intention healing and graft reconstruction methods, may benefit from additional psychological care., (© 2023 John Wiley & Sons Ltd.)
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- 2023
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6. Optical coherence tomography versus punch biopsy for diagnosis of basal cell carcinoma: a multicentre, randomised, non-inferiority trial.
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Adan F, Nelemans PJ, Essers BAB, Brinkhuizen T, Dodemont SRP, Kessels JPHM, Quaedvlieg PJF, Dermont GJ, Winnepenninckx VJL, Abdul Hamid M, Kelleners-Smeets NWJ, and Mosterd K
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- Adolescent, Adult, Biopsy, Humans, Netherlands, Tomography, Optical Coherence, Treatment Outcome, Carcinoma, Basal Cell diagnostic imaging, Carcinoma, Basal Cell therapy, Skin Neoplasms
- Abstract
Background: Punch biopsy is the gold standard for diagnosis and subtyping of basal cell carcinoma. The aim of this study was to assess whether use of optical coherence tomography (OCT), a non-invasive imaging tool, might avoid the need for biopsy., Methods: In a multicentre, randomised, non-inferiority trial, patients (aged ≥18 years) with an indication for biopsy of a suspected basal cell carcinoma outside the H-zone (high-risk zone) of the face were randomly assigned (1:1) to receive either OCT or punch biopsy (regular care) via a web-based randomisation system. Patients were enrolled from three participating centres in the Netherlands: Maastricht University Medical Centre+, Catharina Hospital Eindhoven, and Zuyderland Medical Centre Heerlen. Stratification factors for randomisation were participating centre and the grade of clinical basal cell carcinoma suspicion (high vs low). The primary endpoint was the proportion of patients free from a recurrent or residual lesion (malignant or premalignant) 12 months after treatment. Modified intention-to-treat and per-protocol analyses were conducted, with a predefined non-inferiority margin of -10%. This trial is registered with ClinicalTrials.gov number, NCT03848078, and is complete., Findings: Between Feb 25, 2019, and Sept 2, 2020, 598 patients were enrolled and randomly assigned to either the regular care group (n=299) or the OCT group (n=299). Data on the primary endpoint were available in 553 patients (n=268 in the regular care group, n=285 in the OCT group). After median follow-up of 12·7 months (IQR 11·2-14·1) in the OCT group and 12·6 months (10·8-14·3) in the regular care group, 253 (94%) of 268 patients in the OCT group and 266 (93%) of 285 patients in the regular care group were free from recurrent or residual lesions (malignant or pre-malignant) 12 months after treatment. According to our modified intention-to-treat analysis, the absolute difference (OCT vs regular care) was 1·07% (95% CI -2·93 to 5·06; one-sided p=0·30), with the lower limit of the 95% CI not exceeding the predefined non-inferiority margin of -10%. Per-protocol analyses led to proportions free from a residual or recurrent lesion (premalignant or malignant) of 95% (250 of 263) in the OCT group and 94% (262 of 278) in the regular care group, and an absolute difference of 0·81% (95% CI -2·98 to 4·60; one-sided p=0·34)., Interpretation: OCT-guided diagnosis and treatment of basal cell carcinoma is non-inferior to regular care punch biopsy. Implementation of OCT for diagnosis of basal cell carcinoma could reduce the number of consultations and invasive procedures., Funding: The Netherlands Organization for Health Research and Development and Maurits en Anna de Kock Stichting., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2022
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7. Cancer worry after facial nonmelanoma skin cancer resection and reconstruction: A 1-year prospective study.
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van Hensbergen LJ, Veldhuizen IJ, Lee EH, Houterman S, Brinkhuizen T, van der Hulst RRWJ, and Hoogbergen MM
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- Humans, Mohs Surgery adverse effects, Prospective Studies, Carcinoma, Basal Cell etiology, Carcinoma, Basal Cell surgery, Carcinoma, Squamous Cell etiology, Carcinoma, Squamous Cell surgery, Skin Neoplasms surgery
- Abstract
Objective: Nonmelanoma skin cancer (NMSC) is one of the most diagnosed cancers in the world, with the number of new occurrences rising every year. Most patients with facial skin cancer experience cancer-related worry. Yet, little is known about their worry during the period after cancer treatment. This study aimed to assess the long-term change of cancer worry after surgical treatment in patients with NMSC., Methods: Patients undergoing surgery for facial NMSC between December 2017 and March 2020 were asked to complete the FACE-Q Skin Cancer-Cancer Worry scale before (baseline), 3-month, and 1-year post-surgery., Results: A total of 151 patients completed the baseline and 3-month, and 99 (65.6%) the 1-year post-operative survey. A significant decrease in cancer worry score was seen between baseline and 3-month post-surgery (p < 0.001). No difference was found between the 3-month and 1-year post-surgery scores (p = 0.78). Less improvement in cancer worry was seen for patients who had one facial skin cancer in their medical history (p = 0.001) and patients who had a history of facial surgery (p < 0.001)., Conclusion: Post-surgery patients still experience cancer worry. Therefore, targeted counseling might be of value when coping with cancer-related concerns. Patients with a history of facial NMSC and patients with a history of facial surgery might benefit from additional counseling., (© 2022 John Wiley & Sons Ltd.)
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- 2022
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8. The effect of topical diclofenac 3% and calcitriol 3 μg/g on superficial basal cell carcinoma (sBCC) and nodular basal cell carcinoma (nBCC): A phase II, randomized controlled trial.
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Brinkhuizen T, Frencken KJ, Nelemans PJ, Hoff ML, Kelleners-Smeets NW, Zur Hausen A, van der Horst MP, Rennspiess D, Winnepenninckx VJ, van Steensel MA, and Mosterd K
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- Administration, Topical, Aged, Anti-Inflammatory Agents, Non-Steroidal administration & dosage, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Apoptosis drug effects, Calcitriol administration & dosage, Calcitriol adverse effects, Carcinoma, Basal Cell chemistry, Carcinoma, Basal Cell pathology, Cell Proliferation drug effects, Diclofenac administration & dosage, Diclofenac adverse effects, Drug Therapy, Combination, Female, Gels, Humans, Ki-67 Antigen analysis, Male, Medication Adherence, Middle Aged, Ointments, Proto-Oncogene Proteins c-bcl-2 analysis, Single-Blind Method, Skin Neoplasms chemistry, Skin Neoplasms pathology, Treatment Outcome, Vitamins administration & dosage, Vitamins adverse effects, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Calcitriol therapeutic use, Carcinoma, Basal Cell drug therapy, Diclofenac therapeutic use, Skin Neoplasms drug therapy, Vitamins therapeutic use
- Abstract
Background: Nonsteroidal anti-inflammatory drugs and vitamin-D derivatives can target signaling pathways activated in basal cell carcinoma (BCC)., Objective: We investigated the efficacy of topically applied diclofenac sodium 3% gel, calcitriol 3 μg/g ointment, and a combination of both in superficial BCC (sBCC) and nodular BCC., Methods: Patients with a primary, histologically proven sBCC (n = 64) or nodular BCC (n = 64) were randomized to topical diclofenac, calcitriol, combination of both, or no topical treatment (control group). After self-application twice daily under occlusion (8 weeks), tumors were excised. Primary outcome was posttreatment expression levels of proliferation (Ki-67) and antiapoptosis (B-cell lymphoma [Bcl-2]) immunohistochemical markers. Secondary outcomes were histologic clearance, adverse events, application-site reactions, and patient compliance., Results: sBCC treated with diclofenac showed a significant decrease in Ki-67 (P < .001) and Bcl-2 (P = .001), and after combination therapy for Ki-67 (P = .012). Complete histologic tumor regression was seen in 64.3% (P = .0003) of sBCC (diclofenac) and 43.8% (P = .007) of sBCC (combination therapy) compared with 0.0% of controls. No significant changes were found in nodular BCC. Application-site reactions were mostly mild to moderate., Limitations: The sample size was small., Conclusion: Our results suggest that topical diclofenac is a promising new treatment for sBCC. Its mode of action differs from available noninvasive therapies, and thus has an additive value., (Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
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- 2016
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9. Locally advanced basal cell carcinoma has a distinct methylation and transcriptomic profile.
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Brinkhuizen T, van Geel M, Denil SL, De Meyer T, Kelleners-Smeets NW, Lohuis PJ, Hoebers FJ, Winnepenninckx VJ, van Steensel MA, and Mosterd K
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- Aged, Biopsy, Carcinoma, Basal Cell diagnostic imaging, Female, Gene Expression Regulation, Neoplastic, Head and Neck Neoplasms diagnostic imaging, Head and Neck Neoplasms genetics, Head and Neck Neoplasms metabolism, Humans, Image Processing, Computer-Assisted, Imaging, Three-Dimensional, Mutation, Neoplasm Invasiveness, Skin Neoplasms diagnostic imaging, Tomography, X-Ray Computed, Carcinoma, Basal Cell genetics, Carcinoma, Basal Cell metabolism, DNA Methylation, Skin Neoplasms genetics, Skin Neoplasms metabolism, Transcriptome
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- 2016
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10. Epidermal cyst formation and hyperkeratosis in a patient treated with vismodegib for locally advanced Basal cell carcinoma.
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Reinders MG, Brinkhuizen T, Soetekouw PM, Kelleners-Smeets NW, Hamid MA, and Mosterd K
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- Anilides therapeutic use, Biopsy, Needle, Carcinoma, Basal Cell pathology, Carcinoma, Basal Cell surgery, Epidermal Cyst pathology, Epidermal Cyst surgery, Face pathology, Follow-Up Studies, Humans, Immunohistochemistry, Keratosis pathology, Keratosis surgery, Male, Middle Aged, Mohs Surgery methods, Neoplasm Invasiveness pathology, Neoplasm Recurrence, Local drug therapy, Neoplasm Recurrence, Local pathology, Neoplasm Staging, Nose pathology, Pyridines therapeutic use, Risk Assessment, Skin Neoplasms surgery, Treatment Outcome, Anilides adverse effects, Carcinoma, Basal Cell drug therapy, Epidermal Cyst chemically induced, Keratosis chemically induced, Pyridines adverse effects, Skin Neoplasms drug therapy, Skin Neoplasms pathology
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- 2015
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11. Acquired resistance to the Hedgehog pathway inhibitor vismodegib due to smoothened mutations in treatment of locally advanced basal cell carcinoma.
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Brinkhuizen T, Reinders MG, van Geel M, Hendriksen AJ, Paulussen AD, Winnepenninckx VJ, Keymeulen KB, Soetekouw PM, van Steensel MA, and Mosterd K
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- Aged, Carcinoma, Basal Cell drug therapy, DNA Mutational Analysis, Female, Humans, Skin Neoplasms drug therapy, Smoothened Receptor, Anilides therapeutic use, Antineoplastic Agents therapeutic use, Carcinoma, Basal Cell genetics, Drug Resistance, Neoplasm genetics, Neoplasm Recurrence, Local genetics, Pyridines therapeutic use, Receptors, G-Protein-Coupled genetics, Skin Neoplasms genetics
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- 2014
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12. Immunohistochemical analysis of the mechanistic target of rapamycin and hypoxia signalling pathways in basal cell carcinoma and trichoepithelioma.
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Brinkhuizen T, Weijzen CA, Eben J, Thissen MR, van Marion AM, Lohman BG, Winnepenninckx VJ, Nelemans PJ, and van Steensel MA
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- Aged, Cell Hypoxia, Female, Humans, Immunohistochemistry, Male, Middle Aged, Neoplastic Syndromes, Hereditary metabolism, Neoplastic Syndromes, Hereditary pathology, Phosphorylation, Staining and Labeling, Statistics, Nonparametric, Carcinoma, Basal Cell metabolism, Carcinoma, Basal Cell pathology, Hypoxia-Inducible Factor 1, alpha Subunit metabolism, Signal Transduction genetics, Skin Neoplasms metabolism, Skin Neoplasms pathology, TOR Serine-Threonine Kinases metabolism
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Background: Basal cell carcinoma (BCC) is the most common cancer in Caucasians. Trichoepithelioma (TE) is a benign neoplasm that strongly resembles BCC. Both are hair follicle (HF) tumours. HFs are hypoxic microenvironments, therefore we hypothesized that hypoxia-induced signalling pathways could be involved in BCC and TE as they are in other human malignancies. Hypoxia-inducible factor 1 (HIF1) and mechanistic/mammalian target of rapamycin (mTOR) are key players in these pathways., Objectives: To determine whether HIF1/mTOR signalling is involved in BCC and TE., Methods: We used immunohistochemical staining of formalin-fixed paraffin-embedded BCC (n = 45) and TE (n = 35) samples to assess activity of HIF1, mTORC1 and their most important target genes. The percentage positive tumour cells was assessed manually in a semi-quantitative manner and categorized (0%, <30%, 30-80% and >80%)., Results: Among 45 BCC and 35 TE examined, expression levels were respectively 81% and 57% (BNIP3), 73% and 75% (CAIX), 79% and 86% (GLUT1), 50% and 19% (HIF1α), 89% and 88% (pAKT), 55% and 61% (pS6), 15% and 25% (pMTOR), 44% and 63% (PHD2) and 44% and 49% (VEGF-A). CAIX, Glut1 and PHD2 expression levels were significantly higher in TE when only samples with at least 80% expression were included., Conclusions: HIF and mTORC1 signalling seems active in both BCC and TE. There are no appreciable differences between the two with respect to pathway activity. At this moment immunohistochemical analyses of HIF, mTORC1 and their target genes does not provide a reliable diagnostic tool for the discrimination of BCC and TE.
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- 2014
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13. Epigenetic changes in Basal Cell Carcinoma affect SHH and WNT signaling components.
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Brinkhuizen T, van den Hurk K, Winnepenninckx VJ, de Hoon JP, van Marion AM, Veeck J, van Engeland M, and van Steensel MA
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- Aged, Case-Control Studies, Female, Gene Expression Regulation, Neoplastic, Humans, Male, Promoter Regions, Genetic genetics, Tumor Cells, Cultured, Tumor Suppressor Proteins genetics, Carcinoma, Basal Cell genetics, DNA Methylation, Epigenesis, Genetic, Hedgehog Proteins genetics, Skin metabolism, Skin Neoplasms genetics, Wnt Proteins genetics
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Background: The genetic background of Basal Cell Carcinoma (BCC) has been studied extensively, while its epigenetic makeup has received comparatively little attention. Epigenetic alterations such as promoter hypermethylation silence tumor suppressor genes (TSG) in several malignancies., Objective: We sought to analyze the promoter methylation status of ten putative (tumor suppressor) genes that are associated with Sonic Hedgehog (SHH), WNT signaling and (hair follicle) tumors in a large series of 112 BCC and 124 healthy control samples by methylation-specific PCR., Results: Gene promoters of SHH (P = 0.016), adenomatous polyposis coli (APC) (P = 0.003), secreted frizzled-related protein 5 (SFRP5) (P = 0.004) and Ras association domain family 1A (RASSF1A) (P = 0.023) showed significantly more methylation in BCC versus normal skin. mRNA levels of these four genes were reduced for APC and SFRP5 in BCC (n = 6) vs normal skin (n = 6). Down regulation of SHH, APC and RASSF1A could be confirmed on protein level as well (P<0.001 for all genes) by immunohistochemical staining. Increased canonical WNT activity was visualized by β-catenin staining, showing nuclear β-catenin in only 28/101 (27.7%) of BCC. Absence of nuclear β-catenin in some samples may be due to high levels of membranous E-cadherin (in 94.1% of the samples)., Conclusions: We provide evidence that promoter hypermethylation of key players within the SHH and WNT pathways is frequent in BCC, consistent with their known constitutive activation in BCC. Epigenetic gene silencing putatively contributes to BCC tumorigenesis, indicating new venues for treatment.
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- 2012
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14. Impact of ankylosing spondylitis on sick leave, presenteeism and unpaid productivity, and estimation of the societal cost.
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Boonen A, Brinkhuizen T, Landewé R, van der Heijde D, and Severens JL
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- Adult, Aged, Employment statistics & numerical data, Epidemiologic Methods, Female, Humans, Male, Middle Aged, Netherlands, Sick Leave economics, Spondylitis, Ankylosing rehabilitation, Work statistics & numerical data, Cost of Illness, Efficiency, Sick Leave statistics & numerical data, Spondylitis, Ankylosing economics
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Aim: To describe the influence of ankylosing apondylitis (AS) on sick leave, presenteeism and unpaid work restrictions and to estimate related productivity costs., Methods: 142 consecutive and unselected patients with AS under the care of rheumatologists participated in a longitudinal observational study and completed the Health and Labour Questionnaire (HLQ) assessing disease-related sick leave, presenteeism and restrictions in unpaid work over the previous 2 weeks. Logistic regressions explored which explanatory variables were associated with work outcome. Productivity loss was valued in monetary terms., Results: Among 72 patients in paid employment, 12% had sick leave over a period of 2 weeks and 53% experienced an adverse influence of AS on work productivity while at work. Over this period they reported on average of 5.8 h sick leave and 2.4 inefficient working hours, for which they estimated an extra 1.9 h were needed to complete unfinished work. Among all patients (n=137), 71% had experienced restrictions in unpaid work during the previous 2 weeks with 42% needing help for these tasks for an average of 8 h. The annual production costs for the total group were euro1451 (95% CI 425 to 2742) per patient for sick leave, euro967 (95% CI 503 to 1496) to compensate for hours worked inefficiently while at work and euro1930 (95% CI 1404 to 2471) to substitute loss of unpaid work production., Conclusion: Patients with AS not only have substantial sick leave but also experience restrictions while being at work and when performing unpaid tasks. Limitations in physical functioning are strongly associated with work restrictions. Societal costs of formal and informal care are comparable with the costs of sick leave and presenteeism combined.
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- 2010
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15. A single-nucleotide deletion in the POMP 5' UTR causes a transcriptional switch and altered epidermal proteasome distribution in KLICK genodermatosis.
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Dahlqvist J, Klar J, Tiwari N, Schuster J, Törmä H, Badhai J, Pujol R, van Steensel MA, Brinkhuizen T, Gijezen L, Chaves A, Tadini G, Vahlquist A, and Dahl N
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- Adult, Base Sequence, Case-Control Studies, Cells, Cultured, Epidermis metabolism, Family, Gene Deletion, Homozygote, Humans, Ichthyosis metabolism, Keratinocytes cytology, Keratinocytes metabolism, Keratosis metabolism, Male, Molecular Sequence Data, Scleroderma, Localized metabolism, Sequence Homology, Nucleic Acid, Syndrome, 5' Untranslated Regions genetics, Epidermis pathology, Ichthyosis genetics, Keratosis genetics, Molecular Chaperones genetics, Polymorphism, Single Nucleotide, Proteasome Endopeptidase Complex metabolism, Scleroderma, Localized genetics, Transcription, Genetic
- Abstract
KLICK syndrome is a rare autosomal-recessive skin disorder characterized by palmoplantar keratoderma, linear hyperkeratotic papules, and ichthyosiform scaling. In order to establish the genetic cause of this disorder, we collected DNA samples from eight European probands. Using high-density genome-wide SNP analysis, we identified a 1.5 Mb homozygous candidate region on chromosome 13q. Sequence analysis of the ten annotated genes in the candidate region revealed homozygosity for a single-nucleotide deletion at position c.-95 in the proteasome maturation protein (POMP) gene, in all probands. The deletion is included in POMP transcript variants with long 5' untranslated regions (UTRs) and was associated with a marked increase of these transcript variants in keratinocytes from KLICK patients. POMP is a ubiquitously expressed protein and functions as a chaperone for proteasome maturation. Immunohistochemical analysis of skin biopsies from KLICK patients revealed an altered epidermal distribution of POMP, the proteasome subunit proteins alpha 7 and beta 5, and the ER stress marker CHOP. Our results suggest that KLICK syndrome is caused by a single-nucleotide deletion in the 5' UTR of POMP resulting in altered distribution of POMP in epidermis and a perturbed formation of the outermost layers of the skin. These findings imply that the proteasome has a prominent role in the terminal differentiation of human epidermis., ((c) 2010 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.)
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- 2010
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16. Radiofrequency and pulsed radiofrequency treatment of chronic pain syndromes: the available evidence.
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van Boxem K, van Eerd M, Brinkhuizen T, Patijn J, van Kleef M, and van Zundert J
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- Back Pain physiopathology, Chronic Disease therapy, Evidence-Based Medicine methods, Humans, Neck Pain physiopathology, Radiculopathy physiopathology, Sacroiliac Joint innervation, Sacroiliac Joint physiopathology, Sacroiliac Joint surgery, Spinal Diseases physiopathology, Spinal Nerve Roots physiopathology, Spinal Nerve Roots surgery, Treatment Outcome, Trigeminal Neuralgia physiopathology, Trigeminal Neuralgia surgery, Zygapophyseal Joint innervation, Zygapophyseal Joint physiopathology, Zygapophyseal Joint surgery, Back Pain surgery, Catheter Ablation statistics & numerical data, Neck Pain surgery, Radiculopathy surgery, Spinal Diseases surgery
- Abstract
There are currently 6 reviews on (pulsed) radiofrequency (RF) for the management of spinal pain. Two reviews on interventional pain management techniques in general also discuss RF. The outcomes of those reviews depend on the type of studies included and the opinion of the reviewers, which may result in different evidence levels. Radiofrequency denervation at the cervical and lumbar level has produced the most solid evidence. The differences in treatment outcome registered in the 5 randomized controlled trials (RCTs) regarding lumbar facet denervation can be attributed to differences in patient selection and/or inappropriate technique. There is not sufficient evidence supporting the use of RF facet denervation for the management of cervicogenic headache. The studies examining the management of cervical radicular pain suggest a comparable efficacy for RF and pulsed RF (PRF). The PRF treatment is supposed to be safer and therefore should be preferred. The superiority of RF treatment adjacent to the lumbar dorsal root ganglion for the management of lumbar radicular pain has not been demonstrated in an RCT. Information regarding RF treatment of sacroiliac joint pain is accumulating. No randomized sham-controlled trials on the value of RF treatment of the Gasserian ganglion for the management of idiopathic trigeminal neuralgia have been published. One RCT indicates superiority of RF over PRF for the management of idiopathic trigeminal neuralgia. Future research to confirm or deny the efficacy of (P)RF should be conducted in carefully selected patient populations. The tests used for patient inclusion in such a trial could potentially help the clinician in selecting patients for this type of treatment. The value of PRF treatment of the peripheral nerves also needs to be confirmed in well-designed trials.
- Published
- 2008
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