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Related Experiment Videos

Electrode positioning in thoracic percutaneous partial rhizotomy: an anatomical study

Robert Jan Stolker1, Arnoud C M Vervest, Lino M P Ramos

  • 1Department of Functional Anatomy, Utrecht University, 3508 TA UtrechtThe Netherlands Tacesklinik für Schmerzbehandlung. 50996 CologneGermany Department of Radiology, University Hospital, 3508 GA UtrechtThe Netherlands.

Pain
|May 1, 1994
PubMed
Summary

Fluoroscopic guidance accurately positions needles for thoracic percutaneous partial rhizotomy, targeting the dorsal root ganglion (DRG). This technique, using bony landmarks, proves reliable for this pain management procedure.

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Area of Science:

  • Neurosurgery
  • Pain Management
  • Anatomy

Background:

  • Percutaneous partial rhizotomy is a pain management technique.
  • Accurate needle placement is crucial for targeting the dorsal root ganglion (DRG).
  • Bony landmarks and imaging guidance are used for thoracic procedures.

Purpose of the Study:

  • To evaluate needle placement accuracy in thoracic percutaneous partial rhizotomy using bony landmarks and fluoroscopic control.
  • To compare the reliability of computed tomography (CT) versus fluoroscopy for needle localization.
  • To determine if needles reach the target dorsal root ganglion (DRG).

Main Methods:

  • Investigation performed in 2 cadavers simulating clinical settings.
  • Needle placement assessed in 46 procedures across thoracic levels T1-T12.

Related Experiment Videos

  • Comparison of needle tip position using fluoroscopy, CT, surface photographs, and stained tissue sections (gold standard).

    • Main Results:

    • Needle tips were located within the DRG in 60.9% of cases and the extradural dorsal root in 30.4%.
    • Fluoroscopic imaging provided more accurate visualization of needle position compared to CT.
    • No pleural punctures occurred; facet joint was pierced in 8/32 drill hole procedures.

    Conclusions:

    • Fluoroscopic control is a reliable method for guiding needle placement in percutaneous partial rhizotomy.
    • The technique, utilizing bony landmarks, allows for standardization and accurate targeting of the DRG.
    • Fluoroscopy enhances precision in this minimally invasive pain intervention.