| Stereotactic Thoracic Ganglionotomy with Trans-zygapophyseal Approach: Case report. |
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Keun Man Shin, Hong Cheol Choi, Young Ryong Choi, Cheol Kim |
1Depeatment of Anesthesiology, College of Medicine, Hallym University and Kangneung Medical Center.
2Department of Anesthesia, Boramae City Hospital, Seoul, Korea. |
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| Abstract |
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The advantage of the radiofrequency lesion method are presented, with excellent control of the lesion volume, excellent control of the lesion process using temperature monitoring to quantify the lesion size, prevent boiling, and to produce differential destruction of neural tissue. The presence of afferent fibers in the ventral root which are spared by dorsal rhizotomy suggested an explanation for the failure of this procedure. Nerve fibers with their cells in the ganglion from ventral root will be destructed with streotactic radiofrequency ganglionotomy. Since the dorsal root ganglion cells are more sensitive to than are other structures within the bundle, one is using a differential heat lesion to specifically affect pain pathways while leaving motor pathways. proprioception, and afferent input relatively intact. In the higher thoracic regions, the pleura can be injured when using an traditional approach.
Hence in the upper thoracic region(T2-T9), this type of approach requires that a small burr-hole be made at the superior aspect of the corresponding thoracic zygapophyseal joint. Stereotactic thoracic dorsal root ganglionotomy have carried out under local anesthesia on an inpatient basis in 6 patients. A series of 5 patients with metastatic cancer pain and a patient with compression fracture have treated with stereotactic radiofrequency lesioning of the thoracic dorsal root ganglion. Four out of these 6 patients have been relieved of pain without serious complications. I think this should be a good armamentarium to the pain therapists in the management of intractable pain. (Korean J Anesthesiol 1997; 32: 857~862) |
| Key Words:
Anatomy; trans-zygapophyseal; Equipment; electrode; radiofrequency; Surgery; thoracic dorsal root ganglionotomy |
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