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

Autor(es)

Fonoff, Erich Talamoni ^{[1, 2]} ; Contreras Lopez, William Omar ^{[1, 2, 3]} ; Almeida de Oliveira, Ywzhe Sifuentes ^{[1, 2]} ; Teixeira, Manoel Jacobsen ^{[1, 2]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Med, Pain Ctr, BR-05508 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Sch Med, Dept Neurol, Div Funct Neurosurg, BR-05508 Sao Paulo - Brazil

^[3] Univ Med Ctr, Dept Stereotact & Funct Neurosurg, Freiburg - Germany

• Tipo de documento: Artigo Científico
• Fonte: JOURNAL OF NEUROSURGERY; v. 124, n. 2, p. 389-396, FEB 2016.
• Citações Web of Science: 1

Resumo

OBJECTIVE The aim of this study was to show that microendoscopic guidance using a double-channel technique could be safely applied during percutaneous cordotomy and provides clear real-time visualization of the spinal cord and surrounding structures during the entire procedure. METHODS Twenty-four adult patients with intractable cancer pain were treated by microendoscopic-guided percutaneous radiofrequency (RF) cordotomy using the double -channel technique under local anesthesia. A percutaneous lateral puncture was performed initially under fluoroscopy guidance to localize the target. When the subarachnoid space was reached by the guiding cannula, the endoscope was inserted for visualization of the spinal cord and surrounding structures. After target visualization, a second needle was inserted to guide the RF electrode. Cordotomy was performed by a standard RF method. RESULTS The microendoscopic double -channel approach provided real-time visualization of the target in 91% of the cases. The other 9% of procedures were performed by the single -channel technique. Significant analgesia was achieved in over 90% of the cases. Two patients had transient ataxia that lasted for a few weeks until total recovery. CONCLUSIONS The use of percutaneous microendoscopic cordotomy with the double-channel technique is useful for specific manipulations of the spinal cord. It provides real-time visualization of the RF probe, thereby adding a degree of safety to the procedure. (AU)

• Processo FAPESP: 11/08529-5 - Estudo controlado e duplamente encoberto sobre o efeito do ozônio aplicado por endoscopia espinhal no tratamento da síndrome dolorosa pós-laminectomia: análise na dor neuropática e não neuropática e sua correlação com o nível de citocinas epidurais
• Beneficiário: Erich Talamoni Fonoff
• Modalidade de apoio: Auxílio à Pesquisa - Regular