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Biomedical subjects

Michael Gofeld

Publications and source records attributed to Michael Gofeld.

6 recordsLinked to original sources
PubMed2006

Bilateral pain relief after unilateral thoracic percutaneous sympathectomy.

PURPOSE: To present a case of unexpected bilateral pain relief following unilateral thoracic percutaneous sympathectomy. CLINICAL FINDINGS: We present a case report where severe ischemic pain due to paraneoplastic Raynaud's syndrome with distal gangrene was successfully treated by means of percutaneous thoracic sympathectomy. A unilateral T2, T3 radiofrequency sympathectomy combined with small volume phenol injection resulted in unexpected bilateral pain relief. CONCLUSION: Our observations from this case report suggest a possible crossover of sympathetic innervation at the cervical and thoracic levels. Percutanenous thoracic radiofrequency sympathectomy is a feasible option for the treatment of refractory ischemic upper limb pain.

Aged↗
PubMed2006

Sonographically guided ilioinguinal nerve block.

OBJECTIVE: The aim of this study was to describe a sonographically guided ilioinguinal nerve block in adults. METHODS: We developed a useful step-by-step technique of sonographically guided ilioinguinal nerve block based on visualization of abdominal muscles, fascial planes, and the branch of the deep circumflex iliac artery. RESULTS: We performed 9 sonographic examinations with subsequent blockade of the ilioinguinal nerve. All injections resulted in a clinically successful sensory block. CONCLUSIONS: This technique is reliable and reproducible. The block is achievable by a low-volume local anesthetic injection. Visualization of the intestines and blood vessels in the abdominal wall may help prevent an inadvertent injury.

Abdomen↗
PubMed2005

New approach for spinal cord stimulation trial.

Spinal cord stimulation trial phase has remained unchanged for years. The common practice to connect a lead to an external transmitter is not optimal. The operational mode of transmitter is different from implanted system and external bulky device interferes with patient's daily routine. Optimization in the trial period may increase patient's satisfaction and improve outcome of upcoming permanent implantation. The proposed new trial design can be a simple and logical solution of the problem.

Journal Article↗
PubMed2004

Anchoring of suboccipital lead: case report and technical note.

Suboccipital stimulation is a relatively new method of neuromodulation for treatment of intractable occipital headache and occipital neuralgia. The most common complication besides an infection is a lead displacement. Anchoring of a lead at the entry place partially solves the problem. Migration of electrode's tip is a major problem so far. A case report of electrode migration and a technique of retrograde lead insertion and subcutaneous anchoring of the tip by means of contralateral incision and suturing of lead is described.

Journal Article↗
PubMed2003

Causes of pain in degenerative bone and joint disease: a lesson from vertebroplasty.

Pain in degenerative bone and joint disease is usually attributed to sensitized nociceptors in inflamed periarticular soft tissues. Here we draw attention to the potential contribution of intrinsic bone innervation. The structure and innervation of articular bone ends is analogous to that of teeth. Although some dental pain derives from inflamed periodontal soft tissue, a more important source is the dentine and root canal. By analogy, pain on weight bearing in osteoarthritis and related conditions may be due to compressive forces applied to the innervation of subchondral bone exposed by erosion of the overlying cartilage. Pain relief obtained by injecting acrylic cement into the bone interior during percutaneous vertebroplasty is consistent with this concept. The development of a new family of pain relief options based on "marrow canal treatment" may be a realistic possibility.

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