• Title/Summary/Keyword: percutaneous treatment

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Clinical Outcome of Percutaneous Trigeminal Nerve Block in Elderly Patients in Outpatient Clinics

  • Seo, Hyek Jun;Park, Chang Kyu;Choi, Man Kyu;Ryu, Jiwook;Park, Bong Jin
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.814-820
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    • 2020
  • Objective : Trigeminal neuralgia (TN) is a severe neuropathic condition that affects several elderly patients. It is characterized by uncontrolled pain that significantly impacts the quality of life of patients. Therefore, the condition should be treated as an emergency. In the majority of patients, pain can be controlled with medication; however, other treatment modalities are being explored in those who become refractory to drug treatment. The use of the trigeminal nerve block with a local anesthetic serves as an excellent adjunct to drug treatment. This technique rapidly relieves the patient of pain while medications are being titrated to effective levels. We report the efficacy and safety of percutaneous trigeminal nerve block in elderly patients with TN at our outpatient clinic. Methods : Twenty-one patients older than 65 years with TN received percutaneous nerve block at our outpatient clinic. We used bupivacaine (1 mL/injection site) to block the supraorbital, infraorbital, superior alveolar, mental, and inferior alveolar nerves according to pain sites of patients. Results : All patients reported relief from pain, which decreased by approximately 78% after 2 weeks of nerve block. The effect lasted for more than 4 weeks in 12 patients and for 6 weeks in two patients. There were no complications. Conclusion : Percutaneous nerve block procedure performed at our outpatient clinic provided immediate relief from pain to elderly patients with TN. The procedure is simple, has no serious side effects, and is easy to apply.

Paraspinal Muscle Sparing versus Percutaneous Screw Fixation: A Prospective and Comparative Study for the Treatment of L5-S1 Spondylolisthesis

  • Jang, Kun-Soo;Kim, Heyun-Sung;Ju, Chang-Il;Kim, Seok-Won;Lee, Sung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.49 no.3
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    • pp.163-166
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    • 2011
  • Objective : Both the paraspinal muscle sparing approach and percutaneous screw fixation are less traumatic procedures in comparison with the conventional midline approach. These techniques have been used with the goal of reducing muscle injury. The purpose of this study was to evaluate and to compare the safety and efficacy of the paraspinal muscle sparing technique and percutaneous screw fixation for the treatment of L5-S1 spondylolisthesis. Methods : Twenty patients who had undergone posterior lumbar interbody fusion (PLIF) at the L5-S1 segment for spondylolisthesis were prospectively studied. They were divided into two groups by screw fixation technique (Group I : paraspinal muscle sparing approach and Group II: percutaneous screw fixation). Clinical outcomes were assessed by Low Back Outcome Score (LBOS) and Visual Analogue Scale (VAS) for back and leg pain at different times after surgery. In addition, modified MacNab's grading criteria were used to assess subjective patients' outcomes 6 months after surgery. Postoperative midline surgical scarring, intraoperative blood loss, mean operation time, and procedure-related complications were analyzed. Results : Excellent or good results were observed in all patients in both groups 6 months after surgery. Patients in both groups showed marked improvement in terms of LBOSs all over time intervals. Postoperative midline surgical scarring and intraoperative blood loss were lower in Group II compared to Group I although these differences were not statistically significant. Low back pain (LBP) and leg pain in both groups also showed significant improvement when compared to preoperative scores. However, at 7 days and 1 month after surgery, patients in Group II had significantly better LBP scores compared to Group I. Conclusion : In terms of LBP during the early postoperative period, patients who underwent percutaneous screw fixation showed better results compared to ones who underwent screw fixation via the paraspinal muscle sparing approach. Our results indicate that the percutaneous screw fixation procedure is the preferable minimally invasive technique for reducing LBP associated with L5-S1 spondylolisthesis.

Effect of Azone on Penetration of Antiviral Agents through Hairless Mouse Skin (무모(無毛) 마우스의 피부를 통한 항바이러스제의 투과와 Azone의 영향)

  • Choi, Seung-Ho;Kim, Johng-Kap
    • Journal of Pharmaceutical Investigation
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    • v.20 no.4
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    • pp.205-208
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    • 1990
  • 1-Dodecylazacycloheptan-2-one (Azone) is a new agent that enhances the percutaneous penetration of a number of different chemicals. BVDU and FEAU were evaluated for their potential efficacy in the treatment of cutaneous herpes simplex virus infections by in vitro studies through hairless mouse skin. This study demonstrates the value of penetration enhancing agent (Azone) and the need for a predictable evaluations in the development of topical antiviral agents.

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Percutaneous Insertion of the Distal Catheter during Ventriculo-Atrial Shunts. A Simple and Reliable Method

  • Kim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.41 no.6
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    • pp.429-431
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    • 2007
  • Although the ventriculo-peritoneal shunt is the treatment of choice when hydrocephalus should be corrected, the ventriculo-atrial shunt still holds strong alternative when the peritonium is precluded due to the several reasons. During the ventriculo-atrial shunt operation, it is not always easy to dissect and find the corresponding venous structures. In this technical note, the author describes a simple method of percutaneous insertion for placement of the atrial end.

Comparison of Treatment Compliance and Nutritional Outcomes among Patients with Nasopharyngeal Carcinoma with and without Percutaneous Endoscopic Gastrostomy during Chemoradiation

  • Peerawong, Thanarpan;Phungrassami, Temsak;Pruegsanusak, Kovit;Sangthong, Rassamee
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5805-5809
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    • 2012
  • Aims: The study aimed to compare treatment compliance and nutritional outcomes in nasopharyngeal carcinoma (NPC) patients during chemoradiation. Methods: Clinical information of patients with NPC that underwent chemoradiation during 2004-2009 were retrieved from the hospital database and retrospectively reviewed. Patients were categorised into a prophylactic percutaneous endoscopic gastrostomy (PPEG) group and a non-PPEG group. Clinical information including treatment compliance, weight, haematological and renal toxicity was compared. Results: A total of 219 patients were reviewed and categorised into PPEG (n=77) and non-PPEG (n=142). Significant differences in absolute percentage weight loss between groups were found from the $3^{rd}$ cycle of chemotherapy. There were 24.2, 20.3 and 24.8% in the third, the fourth and the fifth cycles of chemotherapy, respectively. Migration of grade 2 to grade 3 weight loss was obviously seen in the $3^{rd}$ cycle as well. A significant difference of grade 3 or more hypokalemia was found with values of 14.3% and 50% in the PPEG and non-PPEG groups, respectively. Other toxicity parameters and treatment compliance were not different between the groups. Conclusions: Use of PPEG resulted in decreased severe weight loss, reduced migration from grade 2 to grade 3 weight loss and reduced hypokalaemia. However, benefits in treatment compliance could not be detected. So consideration of PPEG in NPC patients requires care.

The Impact of the Amount of Displacement of Percutaneous Osteotomy on the Clinical Result in Bunionette (소건막류에서 경피적 절골술의 전위 정도가 임상 결과에 미치는 영향)

  • Bae, Su-Young;Lee, Seung-Joo;Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.2
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    • pp.63-68
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    • 2015
  • Purpose: The purpose of this study was to report impacts of the amount of displacement of percutaneous osteotomy on the clinical and radiologic results in the treatment of bunionette deformities. Materials and Methods: We retrospectively reviewed 36 cases of bunionette deformities treated with percutaneous modified Kramer osteotomies from 2009 to 2013. We measured amounts of displacement on anteroposterior and lateral plain radiographs as well as multiple parameters which represent degrees of the bunionette deformities. We also recorded radiological healing time, clinical healing time, residual symptoms, and the time of returning to daily activity. Results: No meaningful correlation was found between severity of preoperative deformity and amount of displacement of the osteotomy. The amount of displacement on a horizontal plane did not affect the healing time, duration of symptoms, or time of returning to daily activity. However, large sagittal displacement was related to duration of postoperative symptoms. Conclusion: Findings of this study suggest that the displacement in percutaneous osteotomy for bunionette deformity does not affect clinical results and healing time. We believe that we do not need to be excessively cautious about how large the displacement we make during the percutaneous modified Kramer osteotomy for the bunionette deformity.

Clinical Outcomes of Percutaneous Lumbar Discectomy Using Dekompressor(R) (Dekompressor(R)를 이용한 요부의 경피적 추간판 감압술의 임상 결과)

  • Han, Sun Sook;Sim, Sung Eun;Kim, Yang Hyun;Lee, Eun Hyoung;Joh, Ju Yeon;Kim, Ji Young;Lee, Sang Chul
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.187-191
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    • 2005
  • Background: Discogenic leg pain is a major cause of health problems, often due to herniation of the intervertebral disc, and has traditionally been treated conservatively or with an open surgical discectomy. Conventional open surgery has many complications, such as nerve root injury, discitis and a relatively high mortality rate; failure of conservative treatments is also common. Recently, the $Dekompressor^{(R)}$ Percutaneous Lumbar Discectomy probe was developed. Herein, we present the early results for a percutaneous lumbar discectomy in herniated lumbar disc disease. Methods: Eleven patients, including 8 men and 3 women, with ages ranging from 22 to 78 years, were enrolled in this study. Those patients with a previous history of back surgery were not excluded from the study. All patients were postoperatively evaluated for their clinical outcomes, such as visual analogue scale (VAS) for pain after 1 and 3 months, reduction in analgesics, functional improvement and overall satisfaction. Results: The percutaneous lumbar discectomy was completed in 11 patients (17 levels), with average reductions in pre-VAS of 61.3 and 60.2% at 1 and 3 months, respectively. Also, 72.7% of patients reported functional improvement, with 81.1% expressing overall satisfaction. There were no procedural related complications. Conclusions: We concluded that a percutaneous lumbar discectomy is a safe and effective treatment modality for a herniated lumbar disc.

Percutaneous Endoscopic Interlaminar Discectomy for L5-S1 Disc Herniation: Axillary Approach and Preliminary Results

  • Lee, Seung-Cheol;Lee, Sang-Ho;Choi, Won-Chul;Choi, Gun;Shin, Song-Woo;Kaul, Richard
    • Journal of Korean Neurosurgical Society
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    • v.40 no.2
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    • pp.79-83
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    • 2006
  • Objective : The purpose of this study was to describe a surgical technique of axillary approach of percutaneous endoscopic interlaminar discectomy for L5-S1 disc herniation and its preliminary results. Methods : From July 2002 to September 2003, 101 patients with lumbar radiculopathy due to L5-S1 disc herniation, who were treated by percutaneous interlaminar endoscopic discectomy, were retrospectively reviewed. There were 57 males and 44 females with a mean age of 44.8 years [range, 18 to 62 years]. The surgery consisted of needle insertion into the epidural space via the interlaminar space, sequential dilatation, and endoscopic discectomy through the axillary area of the S1 root. Results : The mean follow-up period was 14.5 months and the average surgical time was 41 min. According to the modified Macnab criteria, 44 patients [43.6%] had excellent outcomes, 49 [48.5%] had good results and only 8 [78%] had fair or poor outcomes. Four patients had a revision microdiscectomy due to incomplete removal of disc fragment. There were no major complications related to this surgical approach. Conclusion : Axillary approach of percutaneous endoscopic interlaminar discectomy is safe and effective procedure for the treatment of L5-Sl disc herniation. It combines the advantages of MED and conventional percutaneous endoscopic discectomy.

Surgical Treatment of the Ruptured Achilles Tendon: A Comparative Study between Percutaneous and Open Repair (급성 아킬레스건 파열의 수술적 치료: 경피적 봉합술과 관혈적 봉합술의 비교)

  • Kim, Do-Yeon;Kim, Sang-Bum;Heo, Youn-Moo;Lee, Jung-Bum;Lim, Jae-Woo;Oh, Hyeong-Tak
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.2
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    • pp.79-85
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    • 2011
  • Purpose: The purpose of the present study was to compare and analyze the clinical outcomes of the percutaneous and open repair of acute Achilles tendon ruptures. Materials and Methods: We performed a retrospective study on 24 patients (group 1) managed with percutaneous repair, and 21 patients (group 2) managed with open repair for acute Achilles tendon rupture. The postoperative evaluations were done by an Arner-Lindholm scale and AOFAS score. Postoperative overall satisfaction and cosmetic satisfaction were also evaluated. Results: By Arner-Lindholm scale and AOFAS score, there was no difference between two groups (p<0.05). As for postoperative overall satisfaction, 5 cases were very satisfied, 16 cases were satisfied and 3 cases were fair in group 1. In group 2, 12 cases were very satisfied, 9 cases were satisfied. For postoperative cosmetic satisfaction, 13 cases were satisfied, 11 cases were fair in group 1. In group 2, 9 cases were very satisfied, 12 cases satisfied. In open repair group, a case of deep wound infection and three cases of skin necrosis were reported as complication. 2 cases of sural nerve injury were seen in percutaneous repair group and were recovered within 3 months. Conclusion: Percutaneous repair of acute Achilles tendon ruptures have high level of cosmetic satisfaction compared with open repair without any significant difference in clinical outcomes.

Diagnosis and resolution of pancreatic pseudocysts with percutaneous ultrasound-guided aspiration in two dogs (개 췌장 위낭종에서 초음파 유도 흡인 생검을 통한 진단 및 치료 2례)

  • Choi, Jihye;Kim, Hyunwook;Seo, Jeemin;Lee, Minjung;Kim, Junyoung;Yoon, Junghee
    • Korean Journal of Veterinary Research
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    • v.47 no.3
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    • pp.341-347
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    • 2007
  • Pancreatic pseudocyst is one of the most common pancreatic mass lesions developed following acute or chronic pancreatitis. Two dogs were presented with nonspecific clinical signs such as abdominal pain, vomiting and depression and diagnosed as pancreatic pseudocysts through percutaneous ultrasound-guided aspiration. Pancreatic pseudocyst may contain pancreatic juice, so leads the deteriorate state of patient through pertinent inflammation and autodigestion of pancreas. In this study, the clinical signs and pancreatic lesion were improved after aspiration. Percutaneous ultrasound-guided aspiration can provide the diagnostic information through cytology and lipase and amylase concentration, and be selected as the first choice for treatment.