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Biomedical subjects

M E Sluijter

Publications and source records attributed to M E Sluijter.

At least 19 recordsLinked to original sources
PubMed1995

Effects of producing a radiofrequency lesion adjacent to the dorsal root ganglion in patients with thoracic segmental pain.

OBJECTIVE: To evaluate the effectiveness of a radiofrequency lesion adjacent to the dorsal root ganglion (RF-DRG) on a consecutive group of patients presenting with chronic thoracic pain. DESIGN: Retrospective study by a disinterested third party. SETTING: Clinical outcome study. PATIENTS: Forty-three patients with a minimum of 6 months history of unilateral thoracic segmental pain, unresponsive to conservative therapy were involved. INTERVENTIONS: Patients were selected for a radiofrequency lesion adjacent to the dorsal root ganglion after two or more prognostic nerve blocks had been performed under fluoroscopic control. The level which provided the best analgesic response was selected. At this level, a radiofrequency lesion was made at 67 degrees for 60 s immediately adjacent to the dorsal root ganglion. OUTCOME MEASURES: Rating of pain was done on a four-step verbal rating scale. RESULTS: A radiofrequency lesion adjacent to the dorsal root ganglion provided short-term (8 weeks) relief of pain in 67% and long-term relief (> 36 weeks) of pain in 52% of patients with a limited segmental distribution of pain. If more than two segmental levels were involved, the procedure was found to be less effective. CONCLUSIONS: There was a significantly (p < 0.05) better short-term and long-term pain relief in patients with a clearly localized pain that was confined to one or two thoracic segmental levels, compared to patients with more than two segmental levels involved in the pain syndrome.

Adolescent↗
PubMed1993

Effects and side effects of a percutaneous thermal lesion of the dorsal root ganglion in patients with cervical pain syndrome.

Twenty consecutive patients with intractable chronic pain in the cervical region were treated with a radiofrequency lesion of the dorsal root ganglion on level C4, C5 or C6. Electromyography (EMG) and sensory evoked potentials (SEP) were recorded before and 3 weeks after the radiofrequency lesion. Side effects were studied 3 weeks, 6 weeks and 3 months after the procedure. Pain scores were evaluated on Numeric Rating Scales (NRS) before and 6 weeks after treatment. The patient was interviewed 3, 6 and 9 months after the radiofrequency lesion. The most common side effect was burning pain in the dermatome of the treated nerve root. Hyposensibility in the dermatome was noticed in 35% of patients. Except in 1 patient, these side effects had disappeared 6 weeks after treatment. The EMG showed no signs of denervation. One SEP recording remained abnormal after treatment. There was initial pain relief in 75% of patients after 3 months and in 50% of the patients after 6 months. In conclusion, this study did not reveal any signs of motor denervation after a percutaneous partial rhizotomy. There were no long-term signs of deafferentation. Initial pain relief was found in 75% of patients, but there was a marked tendency for pain to recur in a period from 3 to 9 months after treatment.

Adult↗
PubMed1988

The use of radiofrequency lesions for pain relief in failed back patients.

If conservative measures fail in the treatment of the failed back patient and if there is no indication for further surgery, interruption of nerve pathways conducting noxious stimuli may be attempted. The indication for such treatment is made on the result of a series of prognostic blocks analysing the conduction pattern of noxious stimuli. A new technique is described to interrupt the grey communicating ramus, conducting afferent fibres from the anterolateral and anterior parts of the annulus fibrosus. Results indicate a discrepancy between the result of radiofrequency lesions and the outcome of prognostic blocks. The discrepancy is more pronounced in failed back patients. Treatment with radiofrequency lesions is well tolerated and it has few adverse effects. It has a measure of success in a group of patients who are very difficult to manage otherwise.

Autonomic Nerve Block↗
PubMed1981

Percutaneous facet denervation and partial posterior rhizotomy.

A classification is given of the types of pain emanating from the vertebral column and associated neural structures. Treatment should primarily be conservative, and if this is not successful surgery should be considered. If pain is still resistant to therapy after these steps percutaneous interruption of afferent stimuli by thermocoagulation may be considered. Two techniques are described. If pain is of the posterior mechanical type, a percutaneous facet denervation may be indicated, both in the lumbosacral and in the cervical area. Small diameter electrodes have been developed, rendering the procedure less painful and considerably reducing postoperative morbidity. For radicular pain confined to one segmental level the method of partial posterior rhizotomy is introduced. In this procedure a partial, selective interruption of stimuli is made in the dorsal root ganglion. The indications, selection of patients, techniques, results and complications of both methods are described. It is concluded that percutaneous facet denervation is an effective method for alleviating posterior mechanical pain. Partial posterior rhizotomy has a worth while success rate considering the fact that there is nothing else to offer to those patients. (Acta anaesth. belg., 1981, 32, 63-80).

Denervation↗
PubMed1980

Interruption of pain pathways in the treatment of the cervical syndrome.

In the cervical syndrome a distinction should be made between an upper and a lower type. The upper type is usually emanating from the intervertebral or facetal joints, since pathology causing nerve-root irritation is confined to the more caudal segments. In the lower type nerve-root irritation is usually the cause of pain but secondary irritation of the facetal joints can be an important contributing factor. Treatment should primarily be conservative. If this fails and if surgical intervention is not indicated an attempt should be made to interrupt pain pathways. This can be done by division of the posterior primary rami or by making a radio-frequency lesion in the dorsal root ganglion. The results indicate these procedures can be of considerable help in a group of patients who do not respond to any other treatment.

Denervation↗
PubMed1979

The treatment of chronic back pain. A preliminary survey of the effect of radiofrequency denervation of the posterior vertebral joints.

Structures innervated by the dorsal primary ramus play a significant part in the genesis of chronic backache and associated leg pain. The features of this syndrome are described and compared with those in the more familiar clinical picture following intervertebral disc degeneration. However these clinical entities are seldom entirely separate and the diagnosis is often also complicated by psychosomatic factors and the consequences of previous back surgery. A technique of percutaneous facet denervation with a radiofrequency probe, although by no means successful in every case, is entirely safe and a very wothwhile procedure. It has helped many patients, who would otherwise have been disabled by pain and restricted in their activities.

Anesthesia, Local↗
PubMed1975

[Pain in carcinoma].

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Autonomic Nerve Block↗