Percutaneous Endoscopic Intercostal Neurectomy for Refractory Intercostal Neuralgia

Pain Physician. 2021 Nov;24(7):E1147-E1153.


Background: Refractory intercostal neuralgia is a troublesome disease with long treatment cycle and short-term therapeutic effects. No treatment modality has given effective pain relief. The authors present here a safe and effective endoscopic surgical option for refractory intercostal neuralgia.

Objectives: To introduce the surgical techniques of percutaneous endoscopic intercostal neurectomy used for refractory intercostal neuralgia and to evaluate its safety and efficacy.

Study design: A retrospective study.

Setting: The Department of Orthopedics at the Hebei General Hospital in China.

Methods: Thirteen patients with refractory intercostal neuralgia were treated with percutaneous endoscopic intercostal neurectomy. Patients were followed up to 12 months postoperatively. The pain was measured by the Visual Analog Scale (VAS) score. Complications, such as aspiration, dysfunction, infection, and local hematoma were analyzed.

Results: Pain was relieved in all 13 patients, with only 1 patient reporting burning sensation along the intercostal nerve distribution area after operation. No other complications were found. All patients had significant improvement, with significantly lower VAS scores recorded postoperatively. No recurrence was reported during the follow-up period.

Limitations: The retrospective nature of this study is a limitation, as well as the small sample size and short observation time.

Conclusions: Endoscopic intercostal neurotomy is an effective and safe minimally invasive surgical treatment for refractory intercostal neuralgia.

Keywords: minimal invasion; percutaneous endoscopic; refractory intercostal neuralgia; Intercostal neurectomy.

MeSH terms

  • Denervation
  • Endoscopy
  • Humans
  • Neuralgia* / surgery
  • Retrospective Studies
  • Treatment Outcome