Article
Cervical selective nerve root block – three-dimensional puncture planning with Dyna-CT is superior to conventional CT-guidance in an ex-vivo model
Die zervikale selektive Nervenwurzelblockade – Die drei-dimensionale Punktionsplanung mittels Dyna-CT ist der konventionellen CT-gesteuerten Punktionsplanung im ex vivo Model überlegen
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Published: | May 8, 2019 |
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Objective: Cervical selective nerve root block (CSNRB) is a widely used percutaneous procedure to diagnose and treat cervical radicular pain. The feasibility of a three-dimensional puncture planning and two-dimensional laser-guidance system has previously been shown in an ex-vivo model. The purpose of this study was to further compare this technique to the conventional computed tomography (CT-)-guided approach.
Methods: 30 CSNRBs were performed, each with Dyna-CT and the Syngo iGuide® laser-guidance system (Artis Zee® Ceiling, Siemens Medical Solutions, Erlangen, Germany), and with conventional CT-guidance (Somatom Volume Zoom, Siemens Healthcare, Erlangen, Germany) in an ex-vivo lamb model. Number of puncture attempts, procedural planning time, puncture time, and puncture depth were evaluated and compared.
Results: All 60 punctures were rated as successful. Significantly less puncture attempts were needed with Dyna-CT compared to conventional CT-guidance (p<0.0001). Procedural planning time and puncture time were significantly shorter with Dyna-CT (pplan.t <0.0001 and ppunc.t=0.0004; median 77s and 56s, respectively) than with conventional CT-guidance (median 109s and 159.5s, respectively). There were no significant differences in puncture depth (Dyna-CT median 3.18cm; conventional CT median 3.33cm, p=0.651).
Conclusion: Dyna-CT with Syngo iGuide® laser-guidance is superior to conventional CT-guidance for CSNRB in an ex-vivo model. It significantly shortens the overall procedure time by reducing planning time, puncture time, and puncture attempts. These advantages could be useful in clinical practice to work more efficiently and increase patient safety.
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