gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

CT guided cryorhizotomy in 66 patients with a lumbar facet syndrome

CT-gestützte Kryotherapie bei 66 Patienten mit lumbalem Facettsyndrom

Meeting Abstract

  • corresponding author Marko Ständer - Ludwig-Maximilians-Universität München, Universitätsklinikum Großhadern, Klinik für Neurochirurgie
  • M. Stander - Neurochirurgische Klinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität, München
  • U. Steude - Neurochirurgische Klinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität, München
  • J.-C. Tonn - Neurochirurgische Klinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität, München
  • U. März - Neurochirurgische Klinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität, München

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocP 14.156

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0440.shtml

Veröffentlicht: 23. April 2004

© 2004 Ständer et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

To evaluate prospectively the therapeutic effect of CT-guided cryorhizotomy on patients with lumbar facet syndrome and to evaluate prognostic factors to predict this effect.

Methods

Between February 2001 and January 2003 CT-guided cryorhizotomy of the facet joint was performed on 66 patients with lumbar facet syndrome (LFS). LFS was diagnosed by at least 3 positive CT-guided medial nerve branch blocks. We used the same target points for medial nerve branch blocks and cryorhizotomy. Patient evaluation were done by clinical evaluation. Patient's follow-up includes a telephone interview 3 days after the procedure and a clinical examination 3 weeks, 3 months and 6 months after cryorhizotomy. In July and August 2003 all patients were clinically reevaluated. Before treatment and on all evaluation points patients had to complete a standardized questionnaire including VAS-scale, medications, ability to work and physical conditions.

Results

The median follow-up was 12 months (7-30 months), median age of patients population was 62 years (30-93 years), 30 patients were male, 36 female. Medium pain free interval was 7 months (0.1-31 months). 65% of patients are pain free for 6 months or longer. Patients without prior operation at the relevant spinal segment had a significantly longer pain-free interval than patients with prior operation (p<0.03). 15 patients got a second, two patients a third cryorhizotomy at the relevant segment. The pain free-interval after the second cryorhizotomy was in the range of the first cryorhizotomy (p>0.5). No patients reported side effects. 3 patients underwent transpedicular fusion after cryorhizotomy. CT-guidance guarantiees an exact needle control and reliable needle positioning for cryorhizotomy with only 12% needle correction.

Conclusions

CT-guided cryorhizotomy is a minimal invasive alternative treatment strategy for patients with lumbar facet syndrome. Cryorhizotomy is specially interesting for patients with risk factors for anesthesia, like old patients and patients with a high cardiac risk profile. In case of pain recurrence, a second cryorhizotomy can be performed. In general, results are better in patients without prior operation of the relevant segment.