慢性疼痛におけるインターベンショナル治療（パルス高周波法）の最近の話題

Recent Topics in Interventional Treatment（Pulsed Radiofrequency）for Chronic Pain

はじめに

　慢性疼痛のインターベンショナル治療で劇的に進歩してきているのは，neuromodulationの領域で，主にはパルス高周波法（pulsed radiofrequency：PRF）と脊髄刺激療法（spinal cord stimulation：SCS）の2つの治療がある。非侵襲的治療として，針を刺さない経皮的な電気，磁気などによるさまざまなneuromodulation機器も開発されてきており，慢性疼痛の治療は，投薬中心の医療からneuromodulationを交えた集学的治療へと変遷してきている。ここではPRFの最近の進歩について述べる。

　Pulsed radiofrequency（PRF）is a treatment modality that relieves pain by an intermittent application of radiofrequency waves to nerve tissue. Unlike radiofrequency thermocoagulation, PRF is not only be applied to nerves including motor nerves；it can also be expected to have a therapeutic effect by acting on peripheral nerve axons. PRF thus has the advantage of being widely applicable.

　Last year, the latest PRF generators were introduced in Japan and overseas.

　PRF uses four frequencies（1, 2, 5, and 10 Hz）and five pulse widths（5, 10, 20, 30, and 50 msec）, A generator was introduced that allows the voltage to be changed arbitrarily from 20 V to 70 V.

　This article provides an overview of PRF therapy, the latest equipment, treatments using the most recently developed parameters, and the mechanism underlying the action of PRF.

　It is hoped that Japan will take the initiative in further developing PRF and conducting clinical research involving PRF.