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Published in: Acta Neurochirurgica 12/2013

01-12-2013 | Clinical Article - Spine

Percutaneous dorsal root ganglion lysis with phenol for the treatment of pain associated with thoracic compression fracture

Authors: Chun-Hsien Lin, Ming-Hsueh Lee, Martin Hsiu-Chu Lin, Ting-Chung Wang, Wan-chun Cheng, Yuan-Hsiung Tsai, Chu-Hsiang Hsu, Jen-Tsung Yang

Published in: Acta Neurochirurgica | Issue 12/2013

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Abstract

Background

Symptomatic thoracic compression fracture is one of the most common causes of back pain in elderly. Although vertebroplasty is widely utilized in patients when conservative treatment fails, we introduced an alternative percutaneous technique for the treatment of thoracic compression pain.

Methods

This in a retrospective study. The analysis was performed on 28 consecutive patients who underwent undergoing percutaneous dorsal root ganglion lysis with phenol for the treatment of pain associated with thoracic compression fracture. An acceptable treatment outcome was operationally defined as a pain intensity numerical rating scale (NRS) score of 3 or lower or EQ-5D index of 0.672 or higher. The primary outcome was pain relief and acceptable treatment outcome at 1 day, 1 week, 1 month, and 1 year.

Results

Of the 28 cases treated with our procedures, the change in mean NRS score between baseline and one day was −2.5 (95 % CI −1.6 ∼ −3.4, p < 0.001), between baseline and one week was −4.7 (−4.1 to −5.3, p < 0.001), between baseline and one month was −5.8 (−5.2 to −6.5, p < 0.001), and between baseline and one year was −6.3 (−5.6 to −7.1, p < 0.001). An acceptable treatment outcome was 14 % one day after the procedure, 46 % at one week, 72 % at one month, and 84 % at one year. Complication rate was 3.6 %.

Conclusions

For thoracic compression fracture patients, percutaneous dorsal root ganglion lysis with phenol is an effective, and safe alternative treatment method worth considering. Pain relief is fast and persists for one year.
Literature
1.
go back to reference Amar AP, Larsen DW, Esnaashari N, Albuquerque FC, Lavine SD, Teitelbaum GP (2001) Percutaneous transpedicular polymethylmethacrylate vertebroplasty for the treatment of spinal compression fractures. Neurosurgery 49:1105–14, discussion 1114–15PubMed Amar AP, Larsen DW, Esnaashari N, Albuquerque FC, Lavine SD, Teitelbaum GP (2001) Percutaneous transpedicular polymethylmethacrylate vertebroplasty for the treatment of spinal compression fractures. Neurosurgery 49:1105–14, discussion 1114–15PubMed
2.
go back to reference Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, Bauer DC, Genant HK, Haskell WL, Marcus R, Ott SM, Torner JC, Quandt SA, Reiss TF, Ensrud KE (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet 348:1535–41PubMedCrossRef Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, Bauer DC, Genant HK, Haskell WL, Marcus R, Ott SM, Torner JC, Quandt SA, Reiss TF, Ensrud KE (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet 348:1535–41PubMedCrossRef
3.
go back to reference Barr JD, Barr MS, Lemley TJ, McCann RM (2000) Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine (Phila Pa 1976) 25(8):923–8CrossRef Barr JD, Barr MS, Lemley TJ, McCann RM (2000) Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine (Phila Pa 1976) 25(8):923–8CrossRef
4.
go back to reference Buonocore M, Aloisi AM, Barbieri M, Gatti AM, Bonezzi C (2010) Vertebral body innervation: implications for pain. J Cell Physiol 222:488–91PubMed Buonocore M, Aloisi AM, Barbieri M, Gatti AM, Bonezzi C (2010) Vertebral body innervation: implications for pain. J Cell Physiol 222:488–91PubMed
5.
go back to reference Chiras J, Depriester C, Weill A, Sola-Martinez MT, Deramond H (1997) Percutaneous vertebral surgery. Technics and indications. J Neuroradiol 24:45–59PubMed Chiras J, Depriester C, Weill A, Sola-Martinez MT, Deramond H (1997) Percutaneous vertebral surgery. Technics and indications. J Neuroradiol 24:45–59PubMed
6.
go back to reference Koch CA, Layton KF, Kallmes DF (2007) Outcomes of patients receiving long-term corticosteroid therapy who undergo percutaneous vertebroplasty. AJNR Am J Neuroradiol 28(3):563–6PubMed Koch CA, Layton KF, Kallmes DF (2007) Outcomes of patients receiving long-term corticosteroid therapy who undergo percutaneous vertebroplasty. AJNR Am J Neuroradiol 28(3):563–6PubMed
7.
go back to reference Christo PJ, Mazloomdoost D (2008) Interventional pain treatments for cancer pain. Ann NY Acad Sci 1138:299–328PubMedCrossRef Christo PJ, Mazloomdoost D (2008) Interventional pain treatments for cancer pain. Ann NY Acad Sci 1138:299–328PubMedCrossRef
8.
go back to reference Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353(9156):878–82PubMedCrossRef Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353(9156):878–82PubMedCrossRef
9.
go back to reference Candido KD, Philip CN, Ghaly RF, Knezevic NN (2010) Transforaminal 5% Phenol Neurolysis for the Treatment of Intractable Cancer Pain. Anesth Analg 110(1):216–9PubMedCrossRef Candido KD, Philip CN, Ghaly RF, Knezevic NN (2010) Transforaminal 5% Phenol Neurolysis for the Treatment of Intractable Cancer Pain. Anesth Analg 110(1):216–9PubMedCrossRef
10.
11.
go back to reference Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM (2001) Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 94(2):149–58PubMedCrossRef Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM (2001) Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 94(2):149–58PubMedCrossRef
12.
go back to reference Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8(9):1137–48PubMedCrossRef Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8(9):1137–48PubMedCrossRef
13.
go back to reference Geurts JW, van Wijk RM, Wynne HJ, Hammink E, Buskens E, Lousberg R, Knape JT, Groen GJ. (2003) Radiofrequency lesioning of dorsal root ganglia for chronic lumbosacral radicular pain: a randomised, double-blind, controlled trial. Lancet. 2003 Jan 4;361(9351):21–6. Geurts JW, van Wijk RM, Wynne HJ, Hammink E, Buskens E, Lousberg R, Knape JT, Groen GJ. (2003) Radiofrequency lesioning of dorsal root ganglia for chronic lumbosacral radicular pain: a randomised, double-blind, controlled trial. Lancet. 2003 Jan 4;361(9351):21–6.
14.
go back to reference Klazen CA, Lohle PN, de Vries J, Jansen FH, Tielbeek AV, Blonk MC, Venmans A, van Rooij WJ, Schoemaker MC, Juttmann JR, Lo TH, Verhaar HJ, van der Graaf Y, van Everdingen KJ, Muller AF, Elgersma OE, Halkema DR, Fransen H, Janssens X, Buskens E, Mali WP (2010) Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open- label randomised trial. Lancet 376:1085–92PubMedCrossRef Klazen CA, Lohle PN, de Vries J, Jansen FH, Tielbeek AV, Blonk MC, Venmans A, van Rooij WJ, Schoemaker MC, Juttmann JR, Lo TH, Verhaar HJ, van der Graaf Y, van Everdingen KJ, Muller AF, Elgersma OE, Halkema DR, Fransen H, Janssens X, Buskens E, Mali WP (2010) Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open- label randomised trial. Lancet 376:1085–92PubMedCrossRef
15.
go back to reference Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, Edwards R, Gray LA, Stout L, Owen S, Hollingworth W, Ghdoke B, Annesley-Williams DJ, Ralston SH, Jarvik JG (2009) A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 361(6):569–579PubMedCrossRef Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, Edwards R, Gray LA, Stout L, Owen S, Hollingworth W, Ghdoke B, Annesley-Williams DJ, Ralston SH, Jarvik JG (2009) A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 361(6):569–579PubMedCrossRef
16.
go back to reference Kowalewski R, Schurch B, Hodler J, Borgeat A (2002) Persistent paraplegia after an aqueous 7.5% phenol solution to the anterior motor root for intercostal neurolysis: a case report. Arch Phys Med Rehabil 83:283–5PubMedCrossRef Kowalewski R, Schurch B, Hodler J, Borgeat A (2002) Persistent paraplegia after an aqueous 7.5% phenol solution to the anterior motor root for intercostal neurolysis: a case report. Arch Phys Med Rehabil 83:283–5PubMedCrossRef
17.
go back to reference Lin MH, Lee M, Wang T, Cheng Y, Su C, Chang C, Yang J (2011) Foramen ovale cannulation guided by intra-operative computed tomography with integrated neuronavigation for the treatment of trigeminal neuralgia. Acta Neurochir (Wien) 153(8):1593–9CrossRef Lin MH, Lee M, Wang T, Cheng Y, Su C, Chang C, Yang J (2011) Foramen ovale cannulation guided by intra-operative computed tomography with integrated neuronavigation for the treatment of trigeminal neuralgia. Acta Neurochir (Wien) 153(8):1593–9CrossRef
18.
go back to reference McHugh GA, Luker KA, Campbell M, Kay PR, Silman AJ (2007) A longitudinal study exploring pain control, treatment and service provision for individuals with end-stage lower limb osteoarthritis. Rheumatology (Oxford) 46(4):631–7CrossRef McHugh GA, Luker KA, Campbell M, Kay PR, Silman AJ (2007) A longitudinal study exploring pain control, treatment and service provision for individuals with end-stage lower limb osteoarthritis. Rheumatology (Oxford) 46(4):631–7CrossRef
19.
go back to reference North RB, Kidd DH, Campbell JN, Long DM (1991) Dorsal root ganglionectomy for failed back surgery syndrome: a 5-year follow-up study. J Neurosurg 74:236–242PubMedCrossRef North RB, Kidd DH, Campbell JN, Long DM (1991) Dorsal root ganglionectomy for failed back surgery syndrome: a 5-year follow-up study. J Neurosurg 74:236–242PubMedCrossRef
20.
go back to reference Pallie W (1959) The intersegmental anastomoses of posterior spinal rootlets and their significance. J Neurosurg 16:188–196PubMedCrossRef Pallie W (1959) The intersegmental anastomoses of posterior spinal rootlets and their significance. J Neurosurg 16:188–196PubMedCrossRef
21.
go back to reference Plancarte R, de Leon-Casasola OA, El-Helaly M, Allende S, Lema MJ (1997) Neurolytic superior hypogastric plexus block for chronic pelvic pain associated with cancer. Regional anesthesia 22(6):562–568PubMed Plancarte R, de Leon-Casasola OA, El-Helaly M, Allende S, Lema MJ (1997) Neurolytic superior hypogastric plexus block for chronic pelvic pain associated with cancer. Regional anesthesia 22(6):562–568PubMed
22.
go back to reference Papanastassiou ID, Phillips FM, Van Meirhaeghe J, Berenson JR, Andersson GB, Chung G, Small BJ, Aghayev K, Vrionis FD (2012) Comparing effects of kyphoplasty, vertebroplasty, and non-surgical management in a systematic review of randomized and non-randomized controlled studies. Eur Spine J 21(9):1826–43PubMedCrossRef Papanastassiou ID, Phillips FM, Van Meirhaeghe J, Berenson JR, Andersson GB, Chung G, Small BJ, Aghayev K, Vrionis FD (2012) Comparing effects of kyphoplasty, vertebroplasty, and non-surgical management in a systematic review of randomized and non-randomized controlled studies. Eur Spine J 21(9):1826–43PubMedCrossRef
23.
go back to reference Raj PP, Lou L, Erdine S, Staats PS, eds.(2008) Interventional Pain Management: Image-Guided Procedures, 2nd ed. Philadelphia: Saunders/Elsevier, pp 49 ∼ 50 Raj PP, Lou L, Erdine S, Staats PS, eds.(2008) Interventional Pain Management: Image-Guided Procedures, 2nd ed. Philadelphia: Saunders/Elsevier, pp 49 ∼ 50
24.
go back to reference Romero-Figueroa S, Aldrete JA, Martinez-Cruz A, Orozco S, Castillo S, Castillo-Henkel C, Guizar-Sahagun G (2006) Nerve root degeneration and regeneration by intrathecal phenol in rats: a morphologic approach. J Peripher Nerv Syst 11(4):310–7PubMedCrossRef Romero-Figueroa S, Aldrete JA, Martinez-Cruz A, Orozco S, Castillo S, Castillo-Henkel C, Guizar-Sahagun G (2006) Nerve root degeneration and regeneration by intrathecal phenol in rats: a morphologic approach. J Peripher Nerv Syst 11(4):310–7PubMedCrossRef
25.
go back to reference Robert F, Haynsworth MD Jr, Carl E, Noe MD (1991) Percutaneous lumbar sympathectomy: A comparison of radiofrequency denervation versus phenol neurolysis. Anesthesiology 74:459–463 Robert F, Haynsworth MD Jr, Carl E, Noe MD (1991) Percutaneous lumbar sympathectomy: A comparison of radiofrequency denervation versus phenol neurolysis. Anesthesiology 74:459–463
26.
go back to reference Scheufler KM, Franke J, Eckardt A, Dohmen H (2011) Accuracy of image-guided pedicle screw placement using intraoperative computed tomography-based navigation with automated referencing. Part II: thoracolumbar spine. Neurosurgery 69(6):1307–16PubMedCrossRef Scheufler KM, Franke J, Eckardt A, Dohmen H (2011) Accuracy of image-guided pedicle screw placement using intraoperative computed tomography-based navigation with automated referencing. Part II: thoracolumbar spine. Neurosurgery 69(6):1307–16PubMedCrossRef
27.
go back to reference Tanigawa N, Kariya S, Komemushi A, Nakatani M, Yagi R, Kohzai M, Sawada S (2011) Percutaneous Vertebroplasty for Osteoporotic Compression Fractures: Long-Term Evaluation of the Technical and Clinical Outcomes. AJR 196:1415–1418PubMedCrossRef Tanigawa N, Kariya S, Komemushi A, Nakatani M, Yagi R, Kohzai M, Sawada S (2011) Percutaneous Vertebroplasty for Osteoporotic Compression Fractures: Long-Term Evaluation of the Technical and Clinical Outcomes. AJR 196:1415–1418PubMedCrossRef
28.
go back to reference Wilkinson HA, Chan AS (2001) Sensory ganglionectomy: theory, technical aspects, and clinical experience. J Neurosurg 95:61–66PubMedCrossRef Wilkinson HA, Chan AS (2001) Sensory ganglionectomy: theory, technical aspects, and clinical experience. J Neurosurg 95:61–66PubMedCrossRef
29.
go back to reference Weksler N, Klein M, Gurevitch B, Rozentsveig V, Rudich Z, Brill S, Lottan M (2007) Phenol neurolysis for severe chronic nonmalignant pain: is the old also obsolete? Pain Med 8:332–7PubMedCrossRef Weksler N, Klein M, Gurevitch B, Rozentsveig V, Rudich Z, Brill S, Lottan M (2007) Phenol neurolysis for severe chronic nonmalignant pain: is the old also obsolete? Pain Med 8:332–7PubMedCrossRef
30.
go back to reference Wang PJ, Shang MY, Qian Z, Shao CW, Wang JH, Zhao XH (2006) CT-guided percutaneous neurolytic celiac plexus block technique. Abdom Imaging 31(6):710–718PubMedCrossRef Wang PJ, Shang MY, Qian Z, Shao CW, Wang JH, Zhao XH (2006) CT-guided percutaneous neurolytic celiac plexus block technique. Abdom Imaging 31(6):710–718PubMedCrossRef
31.
go back to reference Young RF (1990) Dorsal rhizotomy and dorsal root ganglionectomy. In: Youmans JR (ed) Neurological Surgery, vol 6, 3rd edn. WB Saunders, Philadelphia, pp 4026–4035 Young RF (1990) Dorsal rhizotomy and dorsal root ganglionectomy. In: Youmans JR (ed) Neurological Surgery, vol 6, 3rd edn. WB Saunders, Philadelphia, pp 4026–4035
Metadata
Title
Percutaneous dorsal root ganglion lysis with phenol for the treatment of pain associated with thoracic compression fracture
Authors
Chun-Hsien Lin
Ming-Hsueh Lee
Martin Hsiu-Chu Lin
Ting-Chung Wang
Wan-chun Cheng
Yuan-Hsiung Tsai
Chu-Hsiang Hsu
Jen-Tsung Yang
Publication date
01-12-2013
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 12/2013
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-013-1887-6

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