Abstract：
OBJECTIVE: Patients with anterior cutaneous nerve entrapment syndrome (ACNES) often require a step-up treatment strategy including abdominal wall injections, pulsed radiofrequency (PRF) or a neurectomy. Long-term success rates of PRF and surgery are largely unknown. The aim of the current study was to report on the long-term efficacy of PRF and neurectomy in ACNES patients who earlier participated in the randomized controlled PULSE trial.
METHODS: Patients who completed the PULSE trial were contacted about pain status and additional treatments in the following years. Treatment success was based on numerical rating scale (NRS) following IMMPACT recommendations and Patient Global Impression of Change (PGIC) scores.
RESULTS: A total of 44 of the original 60 patients were eligible for analysis (73.3%). Median follow-up was 71.5 months. One patient (4.3%) was still free of pain after a single PRF session, and five additional patients (21.7%) were free of pain by repetitive PRF treatments. By contrast, 13 patients (61.9%) in the neurectomy group were still free of pain without additional treatments. All pain recurrences and therefore primary re-interventions occurred in the first 2 years after the initial treatment.
CONCLUSIONS: Approximately one in five ACNES patients undergoing PRF treatment reports long-term success obviating the need of surgical intervention. Surgery for ACNES is long-term effective in approximately two of three operated patients. Recurrent ACNES beyond 2 years after either intervention is rare.
METHODS: Patients who completed the PULSE trial were contacted about pain status and additional treatments in the following years. Treatment success was based on numerical rating scale (NRS) following IMMPACT recommendations and Patient Global Impression of Change (PGIC) scores.
RESULTS: A total of 44 of the original 60 patients were eligible for analysis (73.3%). Median follow-up was 71.5 months. One patient (4.3%) was still free of pain after a single PRF session, and five additional patients (21.7%) were free of pain by repetitive PRF treatments. By contrast, 13 patients (61.9%) in the neurectomy group were still free of pain without additional treatments. All pain recurrences and therefore primary re-interventions occurred in the first 2 years after the initial treatment.
CONCLUSIONS: Approximately one in five ACNES patients undergoing PRF treatment reports long-term success obviating the need of surgical intervention. Surgery for ACNES is long-term effective in approximately two of three operated patients. Recurrent ACNES beyond 2 years after either intervention is rare.
摘要：
目的：患有前皮神经卡压综合征（ACNES）的患者通常需要采取加强治疗策略，包括腹壁注射，脉冲射频（PRF）或神经切除术。PRF和手术的长期成功率在很大程度上是未知的。本研究的目的是报告PRF和神经切除术在早期参与随机对照PULSE试验的ACNES患者中的长期疗效。
方法：完成PULSE试验的患者在接下来的几年中接触疼痛状态和其他治疗方法。治疗成功基于IMMPACT建议和患者总体变化印象（PGIC）评分后的数字评定量表（NRS）。
结果：最初的60例患者中有44例符合分析条件（73.3％）。中位随访时间为71.5个月。一名患者（4.3%）在一次PRF治疗后仍然没有疼痛，另外5名患者(21.7%)通过重复的PRF治疗没有疼痛。相比之下,神经切除术组的13例患者（61.9％）在没有额外治疗的情况下仍然没有疼痛。所有疼痛复发，因此主要的重新干预发生在初始治疗后的前2年。
结论：大约五分之一接受PRF治疗的ACNES患者报告长期成功，无需手术干预。ACNES的手术在三名手术患者中约有两名是长期有效的。在任何一种干预后超过2年的复发ACNES是罕见的。
方法：完成PULSE试验的患者在接下来的几年中接触疼痛状态和其他治疗方法。治疗成功基于IMMPACT建议和患者总体变化印象（PGIC）评分后的数字评定量表（NRS）。
结果：最初的60例患者中有44例符合分析条件（73.3％）。中位随访时间为71.5个月。一名患者（4.3%）在一次PRF治疗后仍然没有疼痛，另外5名患者(21.7%)通过重复的PRF治疗没有疼痛。相比之下,神经切除术组的13例患者（61.9％）在没有额外治疗的情况下仍然没有疼痛。所有疼痛复发，因此主要的重新干预发生在初始治疗后的前2年。
结论：大约五分之一接受PRF治疗的ACNES患者报告长期成功，无需手术干预。ACNES的手术在三名手术患者中约有两名是长期有效的。在任何一种干预后超过2年的复发ACNES是罕见的。
