Результаты поиска

Use of a Laryngeal Mask Airway Decreases Radiation Exposure During Computed Tomography-Guided Percutaneous Glycerol Rhizotomy for Trigeminal Neuralgia.

BACKGROUND: We have been using computed tomography (CT) guidance for percutaneous glycerol rhizotomy (PGR) for the last 7 years. As a quality improvement exercise, we recently began using general anesthesia (GA) with the use of a laryngeal mask airway (LMA) because of our perception that the procedure went faster and that there was less radiation exposure because of less patient movement. We aim to compare PGR radiation exposure and procedural time between patients receiving local anesthetic with sedation and those receiving GA/LMA. METHODS: A single-center historical cohort study was perform…

Comparative efficacy of microvascular decompression and radiofrequency rhizotomy in idiopathic trigeminal neuralgia with a neurovascular contact without root distortion.

OBJECTIVE: This study aimed to compare the long-term pain control outcomes between microvascular decompression (MVD) and radiofrequency rhizotomy (RFR) in patients with idiopathic trigeminal neuralgia (TN) with a neurovascular contact without root distortion after first-time surgical treatment, as there is no clear recommendation for choosing between these surgical modalities for this patient group. METHODS: This retrospective study evaluated patients diagnosed with idiopathic TN with a neurovascular contact without root distortion. Patients treated with MVD or RFR as first-time surgical trea…

Краткосрочное и долгосрочное облегчение боли с помощью радиочастотной ризотомии у пациентов с множественным склерозом с тригеминальной невралгией: систематический обзор.

У пациентов с множественным склерозом (MS) тригеминальная нейронгия (TN) является изнурительным заболеванием, которое часто не дает медицинской помощи. Радиочастотная ризотомия (RFR) является широко распространенным вмешательством, однако ее результаты в этой конкретной группе населения требуют всеобъемлющего синтеза. Цель этого систематического обзора заключается в оценке краткосрочных и долгосрочных мер по облегчению боли, коэффициентов рецидива и характеристик безопасности RFR у пациентов, имеющих связанные с MS TN (MS-TN). Систематический поиск PubMed, Scopus, Web of Science и Embase был п

Совпадение в аннотации оригинала
Trigeminal neuralgia (TN) in patients with multiple sclerosis (MS) is a debilitating condition that is often refractory to medical management. Radiofrequency rhizotomy (RFR) is a commonly used percutaneous intervention, but its outcomes in this specific population require a comprehensive synthesis. This systematic review aims to evaluate the short- and long-…

The Effect of Selective Dorsal Rhizotomy on Hip Displacement in Children With Cerebral Palsy: A Long-term Follow-up Study.

BACKGROUND: Hip displacement is common in children with cerebral palsy (CP). Spasticity in the hip adductor muscles, hip flexors, and medial hamstrings has been identified as a possible cause of progressive hip displacement. Selective dorsal rhizotomy (SDR) aims to reduce lower extremity spasticity in children with CP. Here, we investigate the influence of SDR on hip displacement in children with CP at long-term follow-up, a minimum of 5 years post-SDR. METHODS: A retrospective review of children undergoing SDR at a Canadian pediatric hospital was completed. Migration percentage (MP) was meas…

A Nod for Meckel: A Novel Surgical Position Utilizing Meckel's Cave Anatomy for Percutaneous Glycerol Rhizotomy in Trigeminal Neuralgia.

Objective  We aim to describe a novel positioning technique using a specific surgical table to achieve the optimal angle during percutaneous glycerol rhizotomy (PGR) for trigeminal neuralgia (TN). Design  This is a descriptive and photographic analysis of successful cases for future implementation. Setting  This study was conducted at a single-institution, academic center. Participants  The participants were adult patients with TN who underwent PGR and provided consent for publication. Main Outcome Measures  Primary outcomes of this study were TN symptomatic relief and surgical complications. …

Intrathecal baclofen, selective dorsal rhizotomy, and extracorporeal shockwave therapy for the treatment of spasticity in cerebral palsy: a systematic review.

Cerebral palsy (CP) is a chronic congenital disorder as the result of abnormal brain development. Children suffering from CP often battle de … majority of the published articles of treatments for CP were reporting the use of selective dorsal rhizotomy (SDR) (54%), and the remainder were of intrathecal baclofen (ITB) pumps (29%) and extracorporeal shockwave therapy (ESWT) (17%). Each method was found to have improvement of spasticity at a rate that achieved statistical significance. ITB pump thera …

Comparative study of Gamma Knife surgery and percutaneous retrogasserian glycerol rhizotomy for trigeminal neuralgia in patients with multiple sclerosis.

OBJECT: Among patients with multiple sclerosis (MS) there is a high incidence of trigeminal neuralgia (TN), and outcomes after treatment seem inferior to those in patients suffering from idiopathic TN. The goal of this study was to evaluate clinical outcomes in patients with MS-related TN after Gamma Knife surgery (GKS) and compare them with those obtained using percutaneous retrogasserian glycerol rhizotomy (PRGR). METHODS: The authors retrospectively reviewed the charts of 45 patients with MS-related TN. The first procedure undertaken was GKS in 27 patients and PRGR in 18 patients. Pain had…

A comparison of continuous epidural infusion and intermittent intravenous bolus doses of morphine in children undergoing selective dorsal rhizotomy.

BACKGROUND AND OBJECTIVES: Selective dorsal rhizotomy (SDR) is associated with moderale to severe postoperative pain. Although the efficacy of epidural analgesia in this population has been demonstrated, it has not been compared with conventional intravenous (i.v.) analgesia. This prospective study compared the effects of epidural and i.v. morphine regarding postoperative analgesia, side effects, and outcomes in children following SDR. METHODS: Twenty-seven children were randomized to receive either epidural or i.v. analgesia. Children in the epidural group had a catheter placed by the neuros…

Localization of bradykinin-like immunoreactivity in the rat spinal cord: effects of capsaicin, melittin, dorsal rhizotomy and peripheral axotomy.

A putative role for bradykinin has been proposed in the processing of sensory information at the level of the spinal cord. Autoradiographic … t the presence of projection neurons to higher cervical centres. Following unilateral lumbar dorsal rhizotomy (L1-L6) or peripheral lesion of the sciatic nerve, important increases of bradykinin-like immunoreactivity were found in laminae III and IV of the ipsilateral dorsal horn. In contrast, significant decreases of immunodeposits were observed in both ce …

The blink reflex before and after percutaneous glycerol rhizotomy in patients with trigeminal neuralgia--a prospective study of 28 patients.

The blink reflex was prospectively studied in 28 patients with trigeminal neuralgia, prior-to and following percutaneous glycerol rhizotomy to the Gasserian ganglion. Fifteen patients (54%) had varying degrees of sensory loss in the trigeminal nerve distribution already before glycerol injection. Three more patients developed sensory loss following glycerol injection. Thus following glycerol injection 18 patients had graded sensory loss. Pre-injection the blink reflex showed abnormal R1 wave in 57% patients, while direct and consensual R2 waves were abnormal in 43% and 48%, respectively. Post-…

An evaluation of sensory changes and pain relief in trigeminal neuralgia following intracranial microvascular decompression and/or trigeminal glycerol rhizotomy.

Nineteen patients with trigeminal neuralgia were treated with either trigeminal ganglion glycerolysis or glycerolysis and intracranial microvascular decompression. All had a good degree of pain relief. Of those receiving glycerol alone (group A), 50% subjectively reported a mild reduction of fine tactile sensation. A similar response was reported by those treated with both glycerol and decompression (group B). The degree of sensory loss was so mild that thermal testing was useless as a discriminatory tool. The degree of sensory loss was not greater when both surgical procedures were performed

Combined dorsal and ventral rhizotomy in non-ambulatory individuals with mixed spastic bilateral cerebral palsy: A prospective registry analysis.

AIM: To establish the efficacy of combined dorsal and ventral rhizotomy (CDVR) and associated quality of life (QoL) changes in individuals with cerebral palsy (CP). METHOD: This was a prospective and consecutive recruitment of patients undergoing CDVR analyzed using retrospective cohort analysis. Spasticity and dystonia were measured using the modified Ashworth and Barry-Albright Dystonia Scales at 3 months and 12 months after surgery. QoL was measured using the Caregiver Priorities and Child Health Index of Life with Disabilities. RESULTS: Thirty-three patients (21 males, 12 females) underw…

Extended Relief at All Spinal Regions and Lower Lumbar VAS: Endoscopic Rhizotomy vs. Radiofrequency Ablation: A Retrospective Cohort Study.

BACKGROUND: Facet joint syndrome accounts for many patients' chronic neck and low back pain. Current interventional treatment options for these conditions include radiofrequency ablation (RFA) and endoscopic rhizotomy (ER), which target the medial branch of the dorsal ramus innervating the facet joint capsule. RFA is a percutaneous procedure in which radiofrequency waves ablate the medial branch. ER, a newer and more invasive procedure, is typically reserved for patients who have not responded to RFA. This retrospective cohort study aims to compare the postoperative pain level (VAS score), dur…

White matter characteristics in children with cerebral palsy prior to selective dorsal rhizotomy: a multicenter diffusion tensor imaging study.

OBJECTIVE: The aims of this study were to 1) assess and quantify white matter (WM) microstructural characteristics derived from diffusion tensor imaging (DTI) in children with cerebral palsy (CP) prior to selective dorsal rhizotomy (SDR), and 2) investigate potential associations between WM diffusion properties and gross motor function and spasticity in children with spastic CP who underwent SDR. METHODS: This study is a multisite study based on DT images acquired prior to SDR as well as postoperative outcome data. DTI data collected from two sites were harmonized using the ComBat approach to…

Navigation-Assisted Full-Endoscopic Radiofrequency Rhizotomy Versus Fluoroscopy-Guided Cooled Radiofrequency Ablation for Sacroiliac Joint Pain Treatment: Comparative Study.

OBJECTIVE: Sacroiliac joint (SIJ) pain is a common cause of chronic low back pain. Full-endoscopic rhizotomy of lateral branches of dorsal rami innervating SIJ is a potential option for patients' refractory to medical treatment. The full-endoscopic rhizotomy is sometimes challenging under fluoroscopic guidance. This study is to evaluate the effectiveness of the navigation-assisted full-endoscopic rhizotomy for SIJ pain. METHODS: The study was a retrospective match-paired study that enrolled consecutive patients undergoing navigation-assisted full-endoscopic rhizotomy for SIJ pain. The patient…

Endoscopically guided foraminal and dorsal rhizotomy for chronic axial back pain based on cadaver and endoscopically visualized anatomic study.

BACKGROUND: Conventional fluoroscopically guided continuous radiofrequency (CRF) and pulsed Radiofrequency (PRF) lesioning of the medial bra … OD: A retrospective non randomized study of 50 initial patients assessed the efficacy of endoscopic rhizotomy. Patients with lumbar spondylosis and facet arthrosis who had at least 50% pain relief by medial branch blocks met the inclusion criteria for the visualized, surgically directed endoscopic technique. A specially designed cannula and endoscope (Richa …

Indications, feasibility safety and efficacy of dorsal rhizotomy at the level of the conus medullaris (conus deafferentation) in individuals with spinal cord injury.

STUDY DESIGN: Retrospective non-controlled intervention study. OBJECTIVES: To assess indications, feasibility, safety and efficacy of dorsal rhizotomy at the level of conus medullaris (conus deafferentation - CDAF) in individuals with spinal cord injury/disease (SCI/D). SETTING: Two specialized tertiary German centers for spinal cord injuries. METHODS: In addition to a detailed description of the surgical procedure (including two technical variants: hemilaminectomy and osteoplastic laminotomy), an analysis of the surgical reports on intra- and postoperative complications and an evaluation o…

A novel indicator to predict the outcome of percutaneous stereotactic radiofrequency rhizotomy for trigeminal neuralgia patients: diffusivity metrics of MR-DTI.

Magnetic resonance-diffusion tensor imaging (MR-DTI) has been used in the microvascular decompression and gamma knife radiosurgery in trigeminal neuralgia (TN) patients; however, use of percutaneous stereotactic radiofrequency rhizotomy (PSR) to target an abnormal trigeminal ganglion (ab-TG) is unreported. Fractional anisotropy (FA), mean and radial diffusivity (MD and RD, respectively), and axial diffusivity (AD) of the trigeminal nerve (CNV) were measured in 20 TN patients and 40 healthy control participants immediately post PSR, at 6-months, and at 1 year. Longitudinal alteration of the dif…