Radiofrequenzläsionen im Bereich der Brust- und Lendenwirbelsäule und des Iliosakralgelenks

  • R. J. Stolker
  • G. J. Groen
  • A. C. M. Vervest
Conference paper


Akute wirbelsäulenbedingte Schmerzen treten häufig auf. Glücklicherweise haben sie eine starke Tendenz zur spontanen Heilung. Unabhängig von einer Behandlung haben nach 90 Tagen nur noch etwa 1% der Betroffenen Schmerzen [63]. Allerdings kommt es in vielen Fällen zu Rezidiven, die der Auftakt zu komplizierten Krankheitsverläufen sein können [28]. Bei diesen chronischen Patienten ist eine Ursache der Beschwerden oft nicht leicht nachzuweisen. Die Beschwerden und Symptome bei der körperlichen Untersuchung sind häufig aspezifisch und entsprechen oft nicht den radiologische Befunden [45].


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Abram SE (1988) Pain mechanisms in lumbar radiculopathy. Anesth Anaig 67:1135–1137Google Scholar
  2. 2.
    Albrektsson B (1981) Sacral rhizotomy in cases of ano-coccygeal pain. Acta Orthop Scand 52:187–190PubMedCrossRefGoogle Scholar
  3. 3.
    Andersen KH, Mosdal C, Värnet K (1987) Percutaneous facet denervation in low-back and extremity pain. Acta Neurochir 87: 48–51CrossRefGoogle Scholar
  4. 4.
    Aprül C, Bogduk N (1992) The prevalence of cervical zygapophyseal joint pain. Spine 17: 744–747CrossRefGoogle Scholar
  5. 5.
    Auteroche P (1983) Innervation of the zygapophyseal joints of the lumbar spine. Anat Clin 5:17–28CrossRefGoogle Scholar
  6. 6.
    Baron R (1995) Schmerz bei peripheren Neuropathien. Welche Rolle spielen nozizeptive C-Afferenzen? Nervenheilkunde 14: 272–277Google Scholar
  7. 7.
    Bernard TN (1990) Lumbar discography followed by computed tomography. Refining the diagnosis of low-back pain. Spine 15: 690–707PubMedCrossRefGoogle Scholar
  8. 8.
    Bogduk N (1983) The innervation of the lumbar spine. Spine 8: 286–293PubMedCrossRefGoogle Scholar
  9. 9.
    Bogduk N, Long DM (1979) The anatomy of the so-called „articular nerves“ and their relationship to facet denervation in the treatment of low-back pain. J Neurosurg 51: 172–177PubMedCrossRefGoogle Scholar
  10. 10.
    Bogduk N, Long DM (1980) Percutaneous lumbar medial branch neurotomy, a modification of facet denervation. Spine 5:193–200PubMedCrossRefGoogle Scholar
  11. 11.
    Bogduk N, Tynan W, Wilson AS (1981) The nerve supply to the human intervertebral discs. J Anat 132: 39–56PubMedGoogle Scholar
  12. 12.
    Bogduk N, Macintosh J, Marsland A (1987) Technical limitations to the efficacy of radiofrequency neurotomy for spinal pain. Neurosurgery 20: 529–535PubMedCrossRefGoogle Scholar
  13. 13.
    Bonica JJ (1990) Causalgia and other reflex sympathetic dystrophies. In: Bonica JJ, Loeser JD, Chapman CR, Fordyce WE (eds) The management of pain. 2nd ed. Lea & Febiger, Philadelphia, pp 220–243Google Scholar
  14. 14.
    Carette S, Marcoux S, Truchon R, Grondin C, Gagnon J, Allard Y, Latulippe M (1991) A controlled trial of corticosteroid injections into facet joints for chronic low back pain. N Engl J Med 325:1002–1007PubMedCrossRefGoogle Scholar
  15. 15.
    Carrera GF (1980) Lumbar facet joint injection in low back pain and sciatica. Description of technique. Radiology 137: 661–664PubMedGoogle Scholar
  16. 16.
    Coggeshall RE, Applebaum ML, Fazen M, Stubbs TB, Sykes MT (1975) Unmyelinated axons in human ventral roots, a possible explanation for the failure of dorsal rhyzotomiy to relieve pain. Brain 98:157–166PubMedCrossRefGoogle Scholar
  17. 17.
    Coppes MH, Marani E, Thomeer RTWM, Oudega M, Groen GJ (1990) Innervation of annulus fibrosis in low back pain. Lancet 336:189–190PubMedCrossRefGoogle Scholar
  18. 18.
    Cosman ER, Nashold BS, Ovelman-Levitt J (1984) Theoretical aspects of radiofrequent lesions in the dorsal root entry zone. Neurosurgery 15: 945–950PubMedCrossRefGoogle Scholar
  19. 19.
    Cosman ER, Cosman BJ (1985) Methods of making nervous system lesions. In: Wilkins RH, Renchary SS (eds) Neurosurgery. McGraw-Hill, New York, pp 2490–2499Google Scholar
  20. 20.
    Crock HV (1986) Internal disc disruption. A challenge to disc prolapse fifty years on. Spine 11: 650–653PubMedCrossRefGoogle Scholar
  21. 21.
    Daum WJ (1995) The sacroiliac joint: an underestimated pain generator. Am J Orthop 24:475–478PubMedGoogle Scholar
  22. 22.
    Destouet JM, Gilula LA, Murphy WA, Monsees B (1982) Lumbar facet joint injection: Indication, technique, clinical correlation, and preliminary results. Radiology 145: 321–325PubMedGoogle Scholar
  23. 23.
    Dory MA (1981) Arthrography of the lumbar facet joints. Radiology 140: 23–27PubMedGoogle Scholar
  24. 24.
    Dreyfuss P, Tibilette C, Dreyer SJ (1994) Thoracic zygapophyseal joint pain patterns. A study in normal volunteers. Spine 19: 807–811PubMedCrossRefGoogle Scholar
  25. 25.
    Dykes RW, Terzis JK (1981) Spinal nerve distributions in the upper limb: the organization of the dermatome and afferent myotome. Philos Trans R Soc Lond B 293: 509–554CrossRefGoogle Scholar
  26. 26.
    Eisenstein SM, Parry CR (1987) The lumbar facet arthrosis syndrome. Clinical presentation and articular surface changes. J Bone Joint Surg 69 B: 3–7Google Scholar
  27. 27.
    Fortin JD, Aprill CN, Ponthieux B, Pier J (1994) Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Spine 19:1483–1489PubMedCrossRefGoogle Scholar
  28. 28.
    Frymoyer JW (1993) Quality: an international challenge to the diagnosis and treatment of disorders of the lumbar spine. Spine 18: 2147–2152PubMedCrossRefGoogle Scholar
  29. 29.
    Gallagher J, Petriccione di Vadi PL, Wedley JR et al. (1994) Radiofrequency facet joint denervation in the treatment of low back pain: a prospective controlled double-blind study to assess it’s efficacy. Pain Clin 7:193–198Google Scholar
  30. 30.
    Gibson MJ, Buckley J, Mawhinney R, Mulholland RC (1986) Magnetic resonance imaging and discography in the diagnosis of disc degeneration. J Bone Joint Surg 68 B: 369–373Google Scholar
  31. 31.
    Gillette RG, Kramis RC, Roberts WJ (1993) Characterization of spinal somatosensory neurons having receptive fields in lumbar tissues of cats. Pain 54: 85–98PubMedCrossRefGoogle Scholar
  32. 32.
    Groen GJ, Baijet B, Boekelaar AB, Drukker J (1987) Branches of the thoracic sympathetic trunk in the human fetus. Anat Embryol 176: 401–411PubMedCrossRefGoogle Scholar
  33. 33.
    Groen GJ, Baljet B, Drukker J (1988) The innervation of the spinal dura mater: anatomy and clinical implications. Acta Neurochir (Wien) 92: 39–46CrossRefGoogle Scholar
  34. 34.
    Groen GJ, Baljet B, Drukker J (1990) Nerves and nerve plexuses of the human vertebral column. Am J Anat 188: 282–296PubMedCrossRefGoogle Scholar
  35. 35.
    Groen GJ, Stoiker RJ, Vervest ACM (1992) Anatomische Grundlagen destruktiver Eingriffe. Der Schmerz 6: 5Google Scholar
  36. 36.
    Gybels JM (1991) Analysis of the outcome of a surgical procedure. Pain 44:103–104PubMedCrossRefGoogle Scholar
  37. 37.
    Haldeman S (1990) Presidential address, North American Spine Society: Failure of the pathology model to predict back pain. Spine 15: 718–724PubMedCrossRefGoogle Scholar
  38. 38.
    Hamann W, Hall S (1992) Acute effect and recovery of primary afferent nerve fibers after graded radiofrequency lesions. Br J Anaesth 68: 443Google Scholar
  39. 39.
    Hasue M, Kikuchi S, Sakuyama Y, Ito T (1983) Anatomic study of the interrelation between lumbosacral nerve roots and their surrounding tissues. Spine 8: 50–58PubMedCrossRefGoogle Scholar
  40. 40.
    Haynsworth RF, Noe CE (1991) Percutaneous lumbar sympathectomy: a comparison of radiofrequency denervation vs. phenol neurolysis. Anesthesiology 74: 459–463PubMedCrossRefGoogle Scholar
  41. 41.
    Heibig T, Lee CK (1988) The lumbar facet syndrome. Spine 13: 61–64CrossRefGoogle Scholar
  42. 42.
    Jackson RP, Jacobs RR, Montesano PX (1988) Facet joint injection in low-back pain. Spine 13: 966–971PubMedCrossRefGoogle Scholar
  43. 43.
    Jackson RP (1992) The facet syndrome. Myth or reality? Clin Orthop 279:110–121PubMedGoogle Scholar
  44. 44.
    Jänig W (1990) The sympathetic nervous system in pain: physiology and pathophysiology. In: Stanton-Hicks M (ed) Pain and the sympathetic nervous system. Kluwer, Boston, pp 17–89Google Scholar
  45. 45.
    Jensen MC, Brant-Zawadski MN, Obuchowski N, Modic MT, Malkasian D, Ross JS (1994) Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med 331: 69–73PubMedCrossRefGoogle Scholar
  46. 46.
    Kikuchi S, Hasue M, Nishiyama K, Ito T (1984) Anatomic and clinical studies of radicular symptoms. Spine 9: 23–30PubMedCrossRefGoogle Scholar
  47. 47.
    Kleef M van, Spaans F, Dingemans W, Barendse GAM, Floor A, Sluijter ME (1993) Effects and side effects of a percutaneous thermal lesion of the dorsal root ganglion in patients with cervical pain syndrome. Pain 52: 49–53PubMedCrossRefGoogle Scholar
  48. 48.
    Kleef M van, Liem L, Lousberg R, Barendse GAM, Kessels AGH, Sluijter ME (1996) Radiofrequency lesion adjacent to the dorsal root ganglion (RF-DRG) for cervicobrachial pain: a prospective double blind randomized study. Neurosurgery 38: 1127–1132PubMedGoogle Scholar
  49. 49.
    Klumpp D, Zimmermann M (1980) Irreversible differential block of A- and C-fibres following local nerve heating in the cat. J Physiol 298: 471–482PubMedGoogle Scholar
  50. 50.
    Kocks W, Roosen K, Demmer G, Kalff R, Grote W (1988) Indikationen und Ergebnisse der sensiblen Rhizotomie bei narbenbedingten lumbalen Wurzelreizsyndromen. Zentr- albl Neurochir 49: 336–339Google Scholar
  51. 51.
    Koning HM, Koster HG, Niemeijer RPE (1991) Ischaemic cord lesion following percutaneous radiofrequency spinal rhizotomy. Pain 45:161–166PubMedCrossRefGoogle Scholar
  52. 52.
    Lilius G, Harilainen A, Laasonen EM, Myllinen P (1990) Chronic unilateral how-back. Tredictors of outcome of facet joint injections. Spine 15: 780–782PubMedGoogle Scholar
  53. 53.
    Loeser JD (1972) Dorsal rhizotomy for the relief of chronic pain. J Neurosurg 29:745–750Google Scholar
  54. 54.
    Lora J, Long DM (1976) So-called facet denervation in the management of intractable back pain. Spine 1:121–126CrossRefGoogle Scholar
  55. 55.
    Lord SM, Barnsley L, Wallis B, McDonald GJ, Bogduk N (1996) Percutaneous radio- frequency neurotomy for chronic cervical zygapophyseal-joint pain. N Engl J Med 335: 1721–1726PubMedCrossRefGoogle Scholar
  56. 56.
    Marks RC (1989) Distribution of pain provoked from lumbar facet joints and related structures during diagnostic spinal infiltration. Pain 39: 37–40PubMedCrossRefGoogle Scholar
  57. 57.
    Marks RC, Houston T, Thulbourne T (1992) Facet joint injection and facet nerve block: a randomised comparison in 86 patients with chronic low back pain. Pain 49: 325–328PubMedCrossRefGoogle Scholar
  58. 58.
    McLachlan EM, Jänig W, Devor M, Michaelis M (1993) Peripheral nerve injury triggers noradrenergic sprouting within dorsal root ganglia. Nature 363: 543–546PubMedCrossRefGoogle Scholar
  59. 59.
    Milette PC, Raymond J, Fontaine S (1990) Comparison of high-resolution computed tomography in the evaluation of lumbar disc herniations. Spine 15: 525–533PubMedCrossRefGoogle Scholar
  60. 60.
    Mooney V, Robertson J (1976) The facet syndrome. Clin Orthop 115:149–156PubMedGoogle Scholar
  61. 61.
    Moore DC (1965) Regional block. Thomas, Springfield, pp 163–166; 211–220Google Scholar
  62. 62.
    Moran R, O’Connell D, Walsh MG (1988) The diagnostic value of facet joint injections. Spine 13:1407–1410PubMedCrossRefGoogle Scholar
  63. 63.
    Nachemson AL (1985) Advances in low back pain. Clin Orthop 200: 266–278PubMedGoogle Scholar
  64. 64.
    Nash TP (1986) Percutaneous radiofrequency lesioning of dorsal root ganglia for intractable pain. Pain 24: 67–73PubMedCrossRefGoogle Scholar
  65. 65.
    Nash TP (1990) Facet joints. Intra-articular steroids or nerve block? Pain Clin 3: 77–82Google Scholar
  66. 66.
    Niv D, Chayen MS (1992) Reduction of localised cancer pain by percutaneous dorsal root ganglia lesions. Pain Clin 5: 229–234Google Scholar
  67. 66a.
    Noe CE, Haynsworth RF (1993) Lumbar raolivfrequency sympathikolysis. I Vase Surg 17: 801–806CrossRefGoogle Scholar
  68. 67.
    North RB, Han M, Zahurak M, Kidd BH (1994) Radiofrequency lumbar facet denervation: analysis of prognostic factors. Pain 57: 77–83PubMedCrossRefGoogle Scholar
  69. 68.
    Onofrio BM, Campa HK (1972) Evaluation of rhizotomy. Review of 12 years experience. J Neurosurg 36: 751–755PubMedCrossRefGoogle Scholar
  70. 69.
    Ovelmen-Levitt J, Johnson B, Bedenbaugh P, Nashold BS (1984) Dorsal root rhizotomy and avulsion in the cat: a comparison of long term effects on dorsal horn neuronal activity. Neurosurgery 15: 921–927PubMedCrossRefGoogle Scholar
  71. 70.
    Pagni CA, Lanotte M, Canavero S (1993) How frequent is anesthesia dolorosa following spinal rhizotomy? A retrospective analysis of fifteen patients. Pain 54: 323–327PubMedCrossRefGoogle Scholar
  72. 71.
    Pagura JR (1983) Percutaneous radiofrequency spinal rhizotomy. Appl Neurophysiol 46: 138–146PubMedGoogle Scholar
  73. 72.
    Pallie W (1959) The intersegmental anastomoses of posterior spinal rootlets and their significance. J Neurosurg 16:188–196PubMedCrossRefGoogle Scholar
  74. 73.
    Purcell-Jones G, Pither CE, Justins DM (1989) Paravertebral somatic nerve block: A clinical, radiographic, computed tomographic study in chronic pain patients. Anesth Analg 68: 32–39Google Scholar
  75. 74.
    Raymond J, Dumas JM (1984) Intraarticular facet block: diagnostic test or therapeutic procedure? Radiology 151: 333–336PubMedGoogle Scholar
  76. 75.
    Rohof OJJM, Stoiker RJ, Vervest ACM (1992) Die Behandlung von sympathischer Reflexdystrophie der oberen Extremitäten mit radiofrequenten Läsionen. Der Schmerz 6:35Google Scholar
  77. 76.
    Rosomoff HL, Fishbain DA, Goldberg M, Santana R, Steele Rosomoff R (1989) Physical findings in patients with chronic intractable benign pain of the neck and/or back. Pain 37: 279–287PubMedCrossRefGoogle Scholar
  78. 77.
    Rydevik BL, Myers RR, Powell HC (1989) Pressure increase in the dorsal root ganglion following mechanical compression. Closed compartment syndrome in nerve roots. Spine 14: 574–574PubMedCrossRefGoogle Scholar
  79. 78.
    Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N (1994) The false positive rate of uncontrolled diagnostic blocks of the lumbar zygapophysial joints. Pain 58:195–200PubMedCrossRefGoogle Scholar
  80. 79.
    Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N (1994) Clinical features of patients with pain stemming from the lumbar zygapophyseal joints. Is the lumbar facet syndrome a clinical entity? Spine 19:1132–1137PubMedCrossRefGoogle Scholar
  81. 80.
    Shealy CN (1976) Facet denervation in the management of back and sciatic pain. Clin Orthop 115:157–164PubMedGoogle Scholar
  82. 81.
    Simmons EH, Segil CM (1975) An evaluation of discography in the localization of symptomatic levels in discogenic disease of the spine. Clin Orthop 108: 57–69PubMedCrossRefGoogle Scholar
  83. 82.
    Sluijter ME (1988) The use of radiofrequency lesions for pain relief in failed back patients. Int Disabil Studies 10: 37–43CrossRefGoogle Scholar
  84. 83.
    Sluijter ME (1989) Radiofrequency lesions of the communicating ramus in the treatment of low back pain. In: Racz GB (ed) Techniques of neurolysis. Kluwer, Boston, pp 145–160Google Scholar
  85. 84.
    Sluijter ME, Mehta M (1981) Treatment of chronic back and neck pain by percutaneous thermal lesions. In: Lipton S (ed) Persistant pain, modern methods of treatment, vol. 3, chapter 8. Academic Press, London, pp 141–179Google Scholar
  86. 85..
    Smith HP, McWhorter JM, Challa VR (1981) Radiofrequency neurolysis in a clinical model. J Neurosurg 55: 246–253PubMedCrossRefGoogle Scholar
  87. 86.
    Solonen KA (1957) The sacroiliac joint in the light of anatomical, roentgenological, and clinical studies. Acta Orthop Scand 27:1–127Google Scholar
  88. 87.
    Sri Kantha K (1989) Radiofrequency percutaneous lumbar sympathectomy; technique and review of indications. In: Racz GB (ed) Techniques of neurolysis. Kluwer, Boston, pp 171–184Google Scholar
  89. 88.
    Stilwell DL (1956) The nerve supply of the vertebral column and its associated structures in the monkey. Anat Ree 125:139–169CrossRefGoogle Scholar
  90. 88a.
    Stoiker RJ, Kamphuis E, Rohof O, Faydherle L, Vervest A (1991) Die Behandlung von Clusterkopfschmerzen mit radiofrequenten Läsionen. Der Schmerz 5:194Google Scholar
  91. 89.
    Stoiker RJ, Vervest ACM, Groen GJ (1993) Percutaneous facet denervation in chronic thoracic spinal pain. Acta Neurochir 122: 82–90CrossRefGoogle Scholar
  92. 90.
    Stoiker RJ, Vervest ACM, Groen GJ (1994) The treatment of chronic thoracic segmental pain by radiofrequency percutaneous partial rhizotomy. J Neurosurg 80: 986–992CrossRefGoogle Scholar
  93. 91.
    Stoiker RJ, Vervest ACM, Groen GJ (1994) The management of chronic spinal pain by blockades: a review. Pain 58:1–20CrossRefGoogle Scholar
  94. 92.
    Stoiker RJ, Vervest ACM, Ramos LMP, Groen GJ (1994) Electrode positioning in thoracic percutaneous partial rhizotomy: an anatomical study. Pain 57: 241–251CrossRefGoogle Scholar
  95. 93.
    Stoiker RJ, Vervest ACM, Groen GJ (1994) Parameters in electrode positioning in thoracic percutaneous facet denervation: an anatomical study. Acta Neurochir 128: 32–39CrossRefGoogle Scholar
  96. 94.
    Sweet WH (1984) Deafferentation pain after posterior rhizotomy, trauma to a limb, and herpes zoster. Neurosurgery 15: 928–932PubMedCrossRefGoogle Scholar
  97. 95.
    Sweet WH, Wepsic JG (1974) Controlled thermocoagulation of trigeminal ganglion and rootlets for differential destruction of pain fibers. J Neurosurg 39:143–156Google Scholar
  98. 96.
    Tajima T, Furukawa K, Kuramochi E (1980) Selective lumbosacral radiculography and block. Spine 5: 68–77PubMedCrossRefGoogle Scholar
  99. 96a.
    Troussier B, Lebas IF, Chirossel IP, Pevc’h M, Grand S, Leviel IL, Phelip X (1995) Perustanevus intradiscal radiofrequency thermocoagulation. A cavavenic Study. Spine 20:1713–1718PubMedCrossRefGoogle Scholar
  100. 97.
    Uematsu S, Udvarhelyi GB, Benson DW, Siebens AA (1974) Percutaneous radiofrequency rhizotomy. Surg Neurol 2: 319–325PubMedGoogle Scholar
  101. 98.
    Umeda S, Arai T, Hatano Y, Mori K, Hoshino K (1987) Cadaver anatomic analysis of the best site for chemical lumbar sympathectomy. Anesth Analg 66: 643–646PubMedCrossRefGoogle Scholar
  102. 99.
    Verdie JC, Lazorthes Y (1976) Thermocoagulation percutanée analgésique des racines rachidiennes. Nouv Presse Méd 11: 2131–2134Google Scholar
  103. 100.
    Vervest ACM, Stoiker RJ (1991) The treatment of cervical pain syndromes with radiofrequency procedures. Pain Clin 4:103–112Google Scholar
  104. 101.
    Vervest ACM, Stoiker RJ, Groen GJ, Tweel I van der (1994) Radiofrequency procedures in chronic cervical pain syndromes: a long term follow-up study. In: Stoiker RJ, Vervest ACM (eds) Pain management by radiofrequency procedures in the cervical and thoracic spine: a clinical and anatomical study. Thesis, Utrecht University, pp 51–62Google Scholar
  105. 102.
    Vinas FC, Zamorano L, Dujovny M, Zhao JZ, Hodgkinson D, Ho KL, Ausman JI (1992) In vivo and in vitro study of the lesions produced with a computerized radiofrequency system. Stereotact Funct Neurosurg 58:121–133PubMedCrossRefGoogle Scholar
  106. 103.
    Wall PD (1992) The placebo effect: an unpopular topic. Pain 51:1–3PubMedCrossRefGoogle Scholar
  107. 104.
    Walsh TR, Weinstein JN, Spratt KF, Lehmann TR, Aprill C, Sayre H (1990) Lumbar discography in normal subjects. J Bone Joint Surg 72 A: 1081–1088PubMedGoogle Scholar
  108. 105.
    Warwick R, Williams PL (1973) Gray’s anatomy, 35th edn. Longman, EdinburghGoogle Scholar
  109. 106.
    Weinstein JN (1986) Mechanisms of spinal pain. The dorsal root ganglion and its role as a mediator of low-back pain. Spine 11: 999–1001PubMedCrossRefGoogle Scholar
  110. 107.
    Weinstein JN (1991) Anatomy and neurophysiologic mechanisms of spinal pain. In: Frymoyer JW (ed) The adult spine. Principles and practice. Raven Press, New York, PP 593–610Google Scholar
  111. 108.
    White JC, Kjellberg RN (1973) Posterior spinal rhizotomy: a substitute for cordotomy in the relief of localized pain in patients with normal life-expectancy. Neurochirurgia 16:141–170PubMedGoogle Scholar
  112. 109.
    Woolf CJ, Wiesenfeld-Hallin Z (1985) The systemic administration of local anaesthetics produces a selective depression of C-afferent fibre evoked activity in the spinal cord. Pain 23: 361–374PubMedCrossRefGoogle Scholar
  113. 110.
    Yabuki S, Kikuchi S (1995) Nerve root infiltration and sympathetic block. Spine 20: 901–906PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • R. J. Stolker
  • G. J. Groen
  • A. C. M. Vervest

There are no affiliations available

Personalised recommendations