ABSTRACT
A 68-year-old woman suffered from lower back and radiating pain on her right buttock and posterior calf. Axial magnetic resonance imaging showed a 7 x 7 mm nodular lesion (T1 and, T2 low signal intensity) at the epidural space between the L5-S1 level and computed tomography revealed it was an epidural gas cyst. The authors performed an epidural block and percutaneous needle aspiration of the epidural gas cyst. The patient showed almost complete resolution of symptoms one year later. The authors suggest that an epidural nerve block with needle aspiration of a gas cyst could be an alternative treatment option for patients with a symptomatic epidural gas cyst before surgery.
Subject(s)
Aged , Female , Humans , Buttocks , Epidural Space , Magnetic Resonance Imaging , Needles , Nerve Block , PolyenesABSTRACT
BACKGROUND: The aim of this study was to document the optimal spacing of two cannulae to form continuous strip lesions and maximal surface area by using water-cooled bipolar radiofrequency technology. METHODS: Two water-cooled needle probes (15 cm length, 18-gauge probe with 6 mm electrode tip) were placed in a parallel position 10, 20, 24, 26, and 28 mm apart and submerged in egg white. Temperatures of the probes were raised from 35degrees C to 90degrees C and the progress of lesion formation was photographed every 1 minute with the increase of the tip temperature. Approximately 30 photographs were taken. The resultant surface areas of the lesions were measured with the digital image program. RESULTS: Continuous strip lesions were formed when the cannulae were spaced 24 mm or less apart; monopolar lesions around each cannula resulted if they were spaced more than 26 mm apart. Maximal surface areas through the formation of continuous strip lesion were 221 mm2, 375 mm2, and 476 mm2 in 10, 20, and 24 mm, respectively. Summations of maximal surface area of each monopolar lesions were 394 mm2 and 103 mm2 in 26 and 28 mm, respectively. CONCLUSIONS: Water-cooled bipolar Radiofrequency technology creates continuous "strip" lesions proportional in size to the distance between the probes till the distance between cannulae is 24 mm or less. Spacing the cannulae 24 mm apart and treating about 80degrees C for 24 minutes maximizes the surface area of the lesion.
Subject(s)
Catheters , Egg White , Electrodes , Needles , OvumABSTRACT
A 54-year-old female was suffering from cold-induced Raynaud's attacks in her both hands with symptoms most severe in her left hand. As the patient did not respond to previous medical treatments and endoscopic thoracic sympathectomy, we performed percutaneous bipolar radiofrequency thoracic sympathicotomy at the left T3 vertebral level. After the procedure, the patient obtained a long duration of symptom relief over 3 years. Percutaneous bipolar radiofrequency T3 sympathicotomy is minimally invasive and effective technique by creating large continuous strip lesion.