J David Prologo1, Charles A Gilliland2, Michael Miller2, Paul Harkey3, Jackie Knight4, Darren Kies2, C Matthew Hawkins2, David Corn4, David K Monson5, Faramarz Edalat3, Sean Dariushnia2, Luke Brewster6. 1. Division of Interventional Radiology, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322. Electronic address: john.david.prologo@emory.edu. 2. Division of Interventional Radiology, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322. 3. Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322. 4. Emory Clinic, Atlanta, Georgia. 5. Department of Orthopaedic Surgery, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322. 6. Department of Surgery, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322.
Abstract
PURPOSE: To prospectively evaluate percutaneous image-guided nerve cryoablation for treatment of refractory phantom limb pain (PLP) in a pilot cohort for purposes of deriving parameters to design a larger, randomized, parallel-armed, controlled trial. MATERIALS AND METHODS:From January 2015 to January 2016, 21 patients with refractory PLP underwent image-guided percutaneous cryoneurolysis procedures. Visual analog scale scores were documented at baseline and 7, 45, and 180 days after the procedure. Responses to a modified Roland Morris Disability Questionnaire were documented at baseline and 7 and 45 days after the procedure. RESULTS:Technical success rate of the procedures was 100%. There were 6 (29%) minor procedure-related complications. Disability scores decreased from a baseline mean of 11.3 to 3.3 at 45-day follow-up (95% confidence interval 5.8, 10.3; P < .0001). Pain intensity scores decreased from a baseline mean of 6.2 to 2.0 at long-term follow-up (95% confidence interval 2.8, 5.6; P < .0001). CONCLUSIONS:Image-guided percutaneous nerve cryoablation is feasible and safe and may represent a new efficacious therapeutic option for patients with phantom pains related to limb loss.
RCT Entities:
PURPOSE: To prospectively evaluate percutaneous image-guided nerve cryoablation for treatment of refractory phantom limb pain (PLP) in a pilot cohort for purposes of deriving parameters to design a larger, randomized, parallel-armed, controlled trial. MATERIALS AND METHODS: From January 2015 to January 2016, 21 patients with refractory PLP underwent image-guided percutaneous cryoneurolysis procedures. Visual analog scale scores were documented at baseline and 7, 45, and 180 days after the procedure. Responses to a modified Roland Morris Disability Questionnaire were documented at baseline and 7 and 45 days after the procedure. RESULTS: Technical success rate of the procedures was 100%. There were 6 (29%) minor procedure-related complications. Disability scores decreased from a baseline mean of 11.3 to 3.3 at 45-day follow-up (95% confidence interval 5.8, 10.3; P < .0001). Pain intensity scores decreased from a baseline mean of 6.2 to 2.0 at long-term follow-up (95% confidence interval 2.8, 5.6; P < .0001). CONCLUSIONS: Image-guided percutaneous nerve cryoablation is feasible and safe and may represent a new efficacious therapeutic option for patients with phantom pains related to limb loss.
Authors: S Nahum Goldberg; Clement J Grassi; John F Cardella; J William Charboneau; Gerald D Dodd; Damian E Dupuy; Debra Gervais; Alice R Gillams; Robert A Kane; Fred T Lee; Tito Livraghi; John McGahan; David A Phillips; Hyunchul Rhim; Stuart G Silverman Journal: Radiology Date: 2005-04-21 Impact factor: 11.105
Authors: Kevin Döring; Carmen Trost; Christoph Hofer; Martin Salzer; Tryphon Kelaridis; Reinhard Windhager; Gerhard M Hobusch Journal: Clin Orthop Relat Res Date: 2021-09-01 Impact factor: 4.755