Biomedical subjects
Publications and source records attributed to H Deda.
C.T.-guided stereotactic destructive pain procedures; percutaneous cordotomy, trigeminal tractotomy-nucleotomy and extralemniscal myelotomy are presented. All procedures were applied in 32 cases without any mispuncture or complication. Advantages of C.T. guidance are direct visualization of target electrode relations, measurements of spinal cord diameters at the lesion site, and demonstration of spinal cord displacement during the procedure.
Percutaneous cordotomy is a commonly applied and effective procedure among the ablative pain surgeries. As plain X-ray does not permit visualization of the target relative to the electrode the chances of obtaining good results are decreased and the risk of complications are increased. The use of CT has been found to be useful in cordotomy. The procedure is performed under CT control on the patients who have previously been given 5 ml iohexol into the subarachnoid space. The needle electrode is manipulated by free hand technique. It is possible to measure the diameter of the spinal cord and to detect cord dislocation in the spinal canal. When the electrode system is introduced it is possible to visualize the tip of the electrode which is pushing or puncturing the spinal cord. As the procedure directly visualizes the relation of the electrode to the target it is possible to place the electrode in the lateral spinothalamic tract. Another advantage of the procedure is to enable us to visualize haematomas or other changes that may result from the cordotomy. The application of the technique and clinical results will be presented.
Trigeminal tractotomy is an effective procedure in denervating pain areas of 5th, 7th, 9th and 10th nerves. The classical imaging technique is the x-ray method which visualizes the target electrode relation indirectly. The method of CT-guided trigeminal tractotomy demonstrates the target electrode relation directly.
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CT guided Extralemniscal Myelotomy (E.M.) is described. Direct visualization of the target is the main advantage of the method. The method was applied successfully in two patients.