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Thermal Radiofrequency Ablation of the Articular Branch of the Lateral Pectoral Nerve: A Case Report and Novel Technique

Eckmann, Maxim S. MD*; Lai, Bryan K. MD*; Uribe, Marco A. III MD; Patel, Samir DO*; Benfield, Jonathan A. DO

doi: 10.1213/XAA.0000000000001090
Case Reports
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The lateral pectoral nerve (LPN) innervates anterior shoulder structures. We report a novel technique for radiofrequency ablation (RFA) of the articular branch of the LPN (abLPN) to treat persistent anterior shoulder pain. Ultrasound and fluoroscopy were used to identify bony and vascular landmarks to target the midlateral and superior-lateral coracoid process (CP). Multiple thermal RFA lesions were delivered along this location without complication using a 20-gauge cannula. As a result, the patient has continued substantial relief of resting and dynamic deep anterior shoulder pain beyond 3 months. Ablation of the abLPN may provide anterior shoulder analgesia without causing motor weakness.

From the *Department of Anesthesiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas;

University of Texas Health Science Center at San Antonio, School of Medicine, San Antonio, Texas;

Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas.

Accepted for publication July 31, 2019.

Conflicts of Interest: See Disclosures at the end of the article.

Funding: Resources required to produce and publish this case report were funded by the Department of Anesthesiology, University of Texas Health Science Center at San Antonio.

Address correspondence to Maxim S. Eckmann, MD, Department of Anesthesiology, University of Texas Health Science Center at San Antonio, Mail Code 7838, 7703 Floyd Curl Dr, San Antonio, TX 78229. Address e-mail to eckmann@uthscsa.edu.

Copyright © 2019 International Anesthesia Research Society
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