gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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

Meeting Abstract

  • presenting/speaker Gregory Ehrlich - Universitätsklinikum Mannheim, Neurochirurgische Klinik, Mannheim, Deutschland
  • Mirko Arp - Universitätsklinikum Mannheim, Neurochirurgische Klinik, Mannheim, Deutschland
  • Manuel Ritter - Universitätsklinikum Mannheim, Urologische Klinik, Mannheim, Deutschland
  • Máté Maros - Universitätsklinikum Mannheim, Abteilung für Neuroradiologie, Mannheim, Deutschland
  • Christoph Groden - Universitätsklinikum Mannheim, Abteilung für Neuroradiologie, Mannheim, Deutschland
  • Daniel Hänggi - Universitätsklinikum Mannheim, Neurochirurgische Klinik, Mannheim, Deutschland
  • Jason Perrin - Universitätsklinikum Mannheim, Neurochirurgische Klinik, Mannheim, Deutschland
  • Hans Ulrich Kerl - Universitätsklinikum Mannheim, Abteilung für Neuroradiologie, Mannheim, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV230

doi: 10.3205/19dgnc249, urn:nbn:de:0183-19dgnc2490

Published: May 8, 2019

© 2019 Ehrlich et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

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.

Figure 1 [Fig. 1]

Figure 2 [Fig. 2]