PMID: 8999444Sep 1, 1996Paper

CT-guided neurolysis. Status of the technique and current results

Der Radiologe
B SchneiderG W Kauffmann

Abstract

Both thoracic and lumbar sympathectomy and celiac ganglion block could be established as effective methods; side effects are rarely reported. Only the high accuracy of CT-guided positioning can make this possible. Severe side effects are merely sporadic if the proper technique is applied. We used 21G or 22G fine needles. All CT-guided percutaneous neurolysis methods require a proper blood coagulation. Most common CT scanners are suitable for neurolysis if there is enough room for maintaining sterile conditions. All neurolysis methods involve sterile puncture of the ganglia under local anesthesia, a test block with anesthetic and contrast agent to assess the clinical effect and the definitive block with a mixture of 96% ethanol and local anesthetic. This allows us to correct the position of the needle if we see improper distribution of the test block or unwanted side effects. Though inflammatory complications of the peritoneum due to puncture are rarely seen, we prefer the dorsal approach whenever possible. Seven of 20 legs showed at least transient clinical improvement after CT-guided lumbar sympathectomies; 13 legs had to be amputated. Results of the methods in the literature differ. For lumbar sympathectomy, improved perfusio...Continue Reading

Citations

Sep 24, 2011·Regional Anesthesia and Pain Medicine·Elena K KrumovaChristoph Maier
Dec 17, 2008·British Journal of Hospital Medicine·Rajaraman Durai, Happy Hoque
May 29, 2009·Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete·F G Bechara
Jun 21, 2011·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Carlos E Garcia FrancoAgustin España

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