PONOS clinical cases
Clinical reasoning, procedures and outcomes over time.
Each case describes an individual pathway: the initial problem, the reasons for the treatment choice, the procedure and follow-up. The results are not a promise of benefit for other patients.
Spinal and radicular pain
Lumbar stenosis: one-year outcomes
Epidural adhesiolysis and left L5 pulsed radiofrequency in an 86-year-old patient. Remission of radicular pain and improved walking ability despite persistent stenosis.
Left C6 radiculopathy after cervical fusion
Paraesthesia persisting for six years: treatment with pulsed radiofrequency and a corticosteroid, with benefit reported for up to twelve months.
Right L5 radiculopathy after spinal fusion
Remission of continuous tingling documented three weeks after pulsed radiofrequency.
Cervical facet joint denervation and occipital nerve neuromodulation
Chronic neck pain in a 49-year-old woman: bilateral C2–C3, C3–C4, C5–C6 and C6–C7 continuous radiofrequency denervation with pulsed radiofrequency of the occipital nerves, with articular benefit at two years.
Craniofacial pain
Bilateral occipital neuralgia
Pulsed radiofrequency neuromodulation: six-month outcomes and residual symptoms.
Refractory trigeminal neuralgia
Severe paroxysmal pain, with an insufficient response to carbamazepine and impaired quality of life.
Read the pathway and follow-up
Treatment: selective radiofrequency of a trigeminal branch under fluoroscopic guidance.
Reported outcome: pain reduction of more than 80%, discontinuation of medication and functional recovery, sustained at six months.
Treatment-resistant chronic cluster headache
Multiple daily attacks, disabling pain and an insufficient response to oxygen and triptans.
Read the pathway and follow-up
Treatment: sphenopalatine ganglion radiofrequency under fluoroscopic guidance.
Reported outcome: a marked reduction in attack frequency and improved quality of life.
Follow-up: the original account describes sustained benefit without specifying a precise duration.
Pelvis and joints
Coccygodynia and sacroiliac pain
Different responses to treatment, with separate outcomes for each painful site.
Hip pain and right L1 radiculopathy in severe rotoscoliosis
An 80-year-old woman with non-operable hip osteoarthritis, severe rotoscoliosis and osteoporosis: neurological assessment identified an L1 radicular component treated with PRF.
Right hip pain: capsular denervation and neuromodulation
A 72-year-old woman: radiofrequency of the hip capsular branches and pulsed neuromodulation, with symptom remission and clinical benefit lasting around five years.
Peripheral and thoracic pain
Intercostal pain after thoracotomy
The role of ultrasound guidance and reported benefit at six and twelve months.
Morton’s neuroma
Interdigital neuropathic pain and difficulty walking after an insufficient response to injections.
Read the pathway and follow-up
Treatment: ultrasound-guided radiofrequency of the neuroma.
Reported outcome: a significant reduction in pain and resumption of daily activities, with no recurrence during the subsequent three years described in the case.
These summaries describe individual pathways previously reported by PONOS Clinic. Individual results and their duration do not predict outcomes for other patients.