MRI-Based Radiation-Free Method for Navigated Percutaneous Radiofrequency Trigeminal Rhizotomy

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Citações na Scopus
8
Tipo de produção
article
Data de publicação
2015
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
THIEME MEDICAL PUBL INC
Autores
MESQUITA FILHO, Paulo Moacir
RAMINA, Kristofer
BISDAS, Sotirios
ERNEMANN, Ulrike
TATAGIBA, Marcos
MORGALLA, Matthias
FEIGL, Guenther
Citação
JOURNAL OF NEUROLOGICAL SURGERY PART A-CENTRAL EUROPEAN NEUROSURGERY, v.76, n.2, p.160-167, 2015
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background/Study Aims Percutaneous radiofrequency trigeminal rhizotomy (RTR) is a standardized treatment for trigeminal neuralgia, yet it has been associated with serious complications related to the cannulation of the foramen ovale. Some of these complications, such as carotid injury, are potentially lethal. Neuronavigation was recently proposed as a method to increase the procedure's safety. All of the techniques described so far rely on pre- or intraoperative computed tomography scanning. Here we present a simple method based on magnetic resonance imaging (MRI) (radiation free) used to target the foramen ovale under navigation guidance. Patients/Material and Methods We retrospectively analyzed nine patients who had undergone navigated percutaneous RTR based solely on preoperative MRI and compared them with 35 patients who underwent conventional RTR guided by fluoroscopy. We analyzed immediate and late outcome and categorized the results into pain free, > 70% pain reduction, and persistent pain. We also compared groups in terms of the duration of the procedure and the complication rates. Here we describe the navigation method in detail and review the anatomical landmarks for target definition. Results The duration of the surgical procedure was similar in both groups (32.1 in the standard technique versus 34.5 minutes with navigation; p = 0.5157). There was no significant difference between groups regarding pain reduction at the immediate (p = 1.0) or late follow-up (p = 0.6284) time points. Furthermore, no serious complications were observed in the navigated group. Conclusions We present a simple radiation-free method for neuronavigation-assisted percutaneous RTR. This method proved to be safe and effective, and it is especially recommended for young, inexperienced neurosurgeons.
Palavras-chave
trigeminal neuralgia, neuronavigation, high-resolution MRI, percutaneous rhizotomy
URI
https://observatorio.fm.usp.br/handle/OPI/9528
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - LIM/15
Artigos e Materiais de Revistas Científicas - ODS/03