Microendoscopic stereotactic-guided percutaneous radiofrequency trigeminal nucleotractotomy

Teixeira, Manoel Jacobsen; Almeida, Fabrício Freitas de; Oliveira, Ywzhe Sifuentes Almeida de; Fonoff, Erich Talamoni

doi:10.3171/2011.8.jns11618

Cited by 7 publications

(15 citation statements)

References 18 publications

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“…This is stereotactic injury of the trigeminal nerve spinal tract oval portion, being indicated for deafferentation facial pain which does not improve after caudal nucleotractotomy 18,19 . The technique is performed with patients in the sitting or lateral position, under local anesthesia.…”

Section: Stereotactic Nucleotractotomy Of Trigeminal Ner-ve Spinal Tractmentioning

confidence: 99%

“…Defficiencies are often permanent, but not disabling, in 40% of patients treated with open trigeminal nucleotractotomy, and in 20% of patients treated with the stereotactic technique. The association of microendoscopy and stereotaxis has increased the advantages of this method as compared to open procedures 3,6,18 . A recent study confirms the long duration (mean of 4.3 years) of good results obtained in atypical trigeminal chronic pain, brachial plexus avulsion, postherpetic neuralgia and phantom limb pain 19 .…”

Section: Stereotactic Nucleotractotomy Of Trigeminal Ner-ve Spinal Tractmentioning

confidence: 99%

“…It improves pain in approxi-mately 60% of patients with atypical facial pain 18,[20][21][22] . Trigeminal nerve spinal tract nucleotractotomy and stereotactic pontine trigeminal nucleotractotomy are effective to treat deafferentation facial pain (Wallemberg syndrome, trigeminal neuropathy pain).…”

Section: Pontine Trigeminal Nucleotractotomymentioning

confidence: 99%

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Invasive treatment to control neuropathic pain

Júnior¹,

Correa

Ferreira

2016

Revista Dor

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BACKGROUND AND OBJECTIVES: Distress, allied to neuropathic pain persistence and its refractory nature, often leads patients to accept invasive procedures. Neuropathic pain control is a major medical challenge requiring approaches and decisions especially based on effectiveness, risks and costs. This study aimed at reviewing these aspects related to major invasive procedures. CONTENTS: Major invasive procedures to control neuropathic pain are presented. Initially, classically reversible anesthetic blocks; then invasive neuromodulation techniques using electric current application and the magnetic field generated by it becomes a target to be stimulated, inhibited or modified in the nervous system (central, peripheral or autonomic); and, finally, ablative procedures including anesthetic methods administering neurolytic agents rather than anesthetics and neurosurgeries using different methods to injure the nervous system to control painful neuropathic discomfort. CONCLUSION: Patients eligible to invasive procedures to control neuropathic pain have, in addition to pain itself, a mixed distress including the collection of repeated delusions at every treatment failure. They have reserved prognosis with regard to total cure and, unfortunately, relieve obtained with invasive treatment in general does not reach persistent and high rates. In such adverse situation, these partial results of decreasing original pain intensity may be interpreted as acceptable, provided the impact on final quality of life is positive. Maybe, the rare exceptions are good results obtained with typical idiopathic/cryptogenic neuralgias ironically excluded from the stricter interpretation of the new pathophysiologic classification of neuropathic pains. Keywords: Anesthetic blocks, Cordectomy, Cortical electrical stimulation, Deep electrical brain stimulation, DREZotomy, Invasive neuromodulation, Medullary electrical stimulation, Neurolytic blocks, Neuropathic pain, Neurosurgery for neuropathic pain, Spinal drugs RESUMO JUSTFICATIVA E OBJETIVOS: O sofrimento aliado à persistência e refratariedade da dor neuropática frequentemente leva seu portador a aceitar tratamentos invasivos. O controle da dor neuropática representa um desafio médico importante necessitando adoção de condutas e decisões baseadas, principalmente, em efetividade, riscos e custos. O escopo deste estudo foi a revisão desses aspectos relacionados aos principais procedimentos invasivos CONTEÚDO: São apresentados os principais procedimentos invasivos utilizados para o controle da dor neuropática. Inicialmente, os bloqueios anestésicos, classicamente reversíveis; depois as técnicas de neuromodulação invasiva que utilizam a aplicação de corrente elétrica e o campo magnético por ela gerado em alvos a serem estimulados, inibidos ou modificados, no sistema nervoso (central, periférico ou autônomo); e, finalmente, os procedimentos ablativos que incluem os métodos anestésicos que administram agentes neurolíticos ao invés de anestésicos, e, as neurocirurgias que utilizam métodos dive...

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Section: Stereotactic Nucleotractotomy Of Trigeminal Ner-ve Spinal Tractmentioning

confidence: 99%

Section: Stereotactic Nucleotractotomy Of Trigeminal Ner-ve Spinal Tractmentioning

confidence: 99%

See 1 more Smart Citation

Invasive treatment to control neuropathic pain

Júnior¹,

Correa

Ferreira

2016

Revista Dor

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“…3 Then microvascular decompression is the most popular method to cure this disease. [4][5][6][7] However, radiofrequency thermocoagulation of the gasserian ganglion is also an effective approach to treat trigeminal neuralgia, especially on elderly people with a high risk of anesthesia and surgery. [8][9][10][11][12] Trigeminal neuralgia secondary to herpes zoster is different from primary trigeminal neuralgia.…”

mentioning

confidence: 99%

Effect of Previous Herpes Zoster on Radiofrequency Thermocoagulation of Gasserian Ganglion for Trigeminal Neuralgia

Zhang

et al. 2015

Neurosurgery Quarterly

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Objective: The aim of this study is to investigate the clinical characteristics, outcomes, and complications of patients with trigeminal neuralgia who underwent radiofrequency thermocoagulation of gasserian ganglion with and without previous herpes zoster. Materials and Methods:The authors analyzed 269 patients with trigeminal neuralgia treated by radiofrequency thermocoagulation of gasserian ganglion in Xinhua hospital between January 1, 2010 and December 31, 2012. A total of 37 patients were secondary to herpes zoster (group I), and 232 patients were primary to trigeminal neuralgia (group II). Clinical outcome data evaluated by visual analogue scale (VAS) scoring and postoperative complications were obtained immediate postoperative, 3 months after operation, and 6 months after operation. Follow-up data were collected from patients when they received reexamination at clinic. Results:In group I and group II, the pain VAS scoring were 0.82 ± 1.26, 0.64 ± 1.52 immediately postoperative, 2.26 ± 2.42, 1.35 ± 2.25 3 months postoperative, 3.85 ± 2.11, and 2.02 ± 1.83 6 months postoperative, respectively. No significant difference in satisfaction score between the 2 groups was observed at the immediate postoperative (P > 0.05), 3 months after operation (P < 0.05), significant difference was observed at 6 months after operation (P < 0.05). No significant differences in postoperative complications were noted between the 2 groups.Conclusions: Radiofrequency thermocoagulation of the gasserian ganglion is an effective and safe procedure for patients of trigeminal neuralgia. Secondary trigeminal neuralgia is inferior to primary in long-term curative effect.

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“…45 In this study, we propose a safer approach for these procedures. Although the first procedures allowed visualization of the spinal cord and targeting guidance by anatomical landmarks, the puncture of the spinal cord itself was performed blindly because of the need to withdraw the microendoscopic optics in order to insert the radiofrequency (RF) electrode into the single work channel.…”

mentioning

confidence: 99%

Microendoscopy-guided percutaneous cordotomy for intractable pain: case series of 24 patients

Fonoff

López

Oliveira

et al. 2016

JNS

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Microendoscopic stereotactic-guided percutaneous radiofrequency trigeminal nucleotractotomy

Abstract: The initial application of this technique suggests that percutaneous microendoscopy may be useful for particular manipulation of the medulla oblongata, increasing the safety of the procedure and likely improving its effectiveness.

Cited by 7 publications

References 18 publications

Invasive treatment to control neuropathic pain

Invasive treatment to control neuropathic pain

Effect of Previous Herpes Zoster on Radiofrequency Thermocoagulation of Gasserian Ganglion for Trigeminal Neuralgia

Microendoscopy-guided percutaneous cordotomy for intractable pain: case series of 24 patients

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