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Computed Tomography‐Guided Percutaneously Controlled Ablation of the Thoracic Paravertebral Nerve Due to Thoracic Neuropathic Pain
Author(s) -
Yang LiQiang,
Gong WeiYi,
Wang XiaoPing,
Dou Zhi,
Zeng YuanJie,
Ni JiaXiang
Publication year - 2017
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12527
Subject(s) - medicine , neuropathic pain , ablation , computed tomography , anesthesia , radiology , surgery
Background Patients with thoracic neuropathic pain often do not respond to medication and physical therapy. Coblation technology has been demonstrated to have potential for pain management. Methods Fifteen patients underwent computed tomography‐guided percutaneous coblation to ablate the thoracic paravertebral nerve for their medication‐resistant thoracic neuropathic pain. The pain intensity was assessed by visual analog scale ( VAS ) 1 day before surgery and 1 week and 1, 3, and 6 months after surgery, and the difference between preoperative and postoperative VAS values was determined to evaluate the pain relief effectiveness. Patients who achieved > 50% pain relief were defined as responders, and the ratio in all patients was calculated. The number of patients who reported mild pain ( VAS ≤ 3) was recorded, and the ratio in all responders was calculated. In addition, adverse effects were also recorded to investigate the security of procedure. Results Twelve (80%) responders achieved > 50% pain relief. The VAS score of responders significantly decreased from 7.42 ± 1.38 before surgery to 2.17 ± 1.11 ( P = 0.000), 1.92 ± 1.16 ( P = 0.000), 1.75 ± 0.97 ( P = 0.000), and 1.58 ± 1.08 ( P = 0.000) at 1 week, 1, 3, and 6 months after surgery, respectively. The number of responders with mild pain was 10 (83.3%), 11 (91.7%), 12 (100%), and 12 (100%) at 1 week, 1, 3, and 6 months after surgery, respectively. All responders and 1 nonresponder reported slight numbness after the surgery. Conclusion Percutaneous thoracic paravertebral nerve coblation guided by computed tomography is a potential method for the treatment of thoracic neuropathic pain.