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Objective To assess the clinical application value of radiofrequency ablation (RFA) by using different-depth needle-puncturing through medial wall of oval foramen under fluoroscopic guidance in treating primary trigeminal neuralgia.Method A total of 32 patients with primary trigeminal neuralgia were enrolled in this study.Guided by fluoroscopic monitoring,RFA by using different-depth needle-puncturing through medial wall of oval foramen was carried out in all patients.The intraoperative exact replication rates of responsible nerve were recorded,and the postoperative one-day,one-week,3-month and one-year cure rates were calculated.Results During the operation,the precise replication rates the neuralgia of branch Ⅰ,branch Ⅱ and branch Ⅲ of the trigeminal nerve were 85.7％(6/7),96.4％ and 100％ respectively.The postoperative one-day,one-week,3-month and one-year cure rates were 87.5％,93.8％,93.8％ and 87.5％ respectively.Conclusion In treating trigeminal neuralgia with RFA,fluoroscopy-guided needle-puncturing through medial wall of oval foramen can accurately replicate the pain symptoms of the dominating region of responsible nerve,thus,the trigeminal neuralgia can be precisely treated.Being minimally-invasive and safe with reliable effectiveness,this technique is worthy of clinical application.
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Objective To investigate and analyze the effect of polyurethane foam sclerotherapy on varicose veins of lower extremity under the guidance of fluoroscopy. Methods 90 patients with varicose veins treated in our hospital from February 2015 to May 2017 were selected and randomly divided into the control group and the experimental group, with 45 patients in each group. The patients in the control group were given conventional high ligation and stripping of the great saphenous vein. The patients in the experimental group were treated with fluoroscopic guided polyurethane foam sclerotherapy. The therapeutic effects of the 2 groups were compared and analyzed. Results After operation, 2 patients relapsed in the experimental group, and the recurrence rate was 4.4％. In the control group, 6 patients relapsed. The recurrence rate (13.3％) in the control group was significantly higher than that in the experimental group, with statistical difference. After the corresponding treatment, the intraoperative blood loss in the experimental group was (10.23±1.52) mL, and the bleeding volume in the control group was (32.19±2.34) mL. The bleeding volume in the experimental group was significantly less than that in the control group, with statistical difference. In addition, the average length of stay, length of operation and length of incision in the experimental group were significantly better than those in the control group, with statistical difference. Conclusion The clinical effect of fluoroscopy guided lauromacrogol foam sclerosing agent in the treatment of varicose vein of lower limb is better, the recurrence rate is low, can significantly reduce the amount of bleeding, shorten operation time, has clinical significance.
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Objective To investigate the success rate of fluoroscopy-guided subclavian vein catheter implantation (SVCI) in children with hematologic diseases,to improve the visualization of the position of the catheter head,and to reduce the incidence of procedure-related complications.Methods Fluoroscopyguided SVCI was performed in 183 sick children (aged 1-16 years) with confirmed hematologic disease.The success rate of the catheter implantation,the number of needle puncturing,the operation time,the fluoroscopy time and the occurrence of procedure-related complications were recorded.Results Successful fluoroscopy-guided SVCI was accomplished in all 183 sick children,with a success rate being 100％.Successful SVCI was obtained with ＜3 times of puncturing in 151 sick children (82.5％),with 4-6 times of puncturing in 25 sick children,and with 7-10 times of puncturing in 7 sick children.The catheter tip was successfully positioned at the junction of the superior vena cava with the right atrium in all sick children.The operation time ranged from 5 min to 25 min with a mean of (10.38±4.04) min.The fluoroscopy time varied from 16 seconds to 607 seconds with a mean of (65.46±55.86) seconds.During the procedure,artery was wrongly punctured two times in two sick children.The mean follow-up time was 35 days.Cather-related infection occurred in 2 sick children.No local hematoma at puncture point,nor hemopneumothorax or catheter-related thrombosis occurred.Conclusion Fluoroscopy-guided SVCI has high technical success rate in children with hematologic diseases.For a successful procedure of SVCI,less number of needle puncturing is needed by using this technique.The satisfaction rate for the placement of catheter tip is high and the incidence of complications is low.Therefore,fluoroscopy-guided SVCI is a safe and effective method.
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A 51-year-old man with a 1-month history of lower back pain and radiating pain visited to our pain clinic. A magnetic resonance imaging (MRI) scan demonstrated a cyst like mass at the level of the L4-5 interspace and compression of the thecal sac and the nerve root on the right side. We performed percutaneous needle aspiration of the lumbar zygapophyseal joint synovial cyst under fluoroscopic guidance. The patient felt an immediate relief of symptoms after the aspiration, and had no signs or symptoms of recurrence at the follow-up 6 months later. No demonstrable lesion was found in the 6 months follow-up MRI.
Subject(s)
Humans , Middle Aged , Follow-Up Studies , Low Back Pain , Magnetic Resonance Imaging , Needles , Pain Clinics , Recurrence , Synovial Cyst , Zygapophyseal JointABSTRACT
OBJECTIVE: The author measured levels of fluoroscopic radiation exposure to the surgeon's body based on the different beam directions during kyphoplasty. METHODS: This is an observational study. A series of 84 patients (96 vertebral bodies) were treated with kyphoplasty over one year. The patients were divided into four groups based on the horizontal and vertical directions of the X-Ray beams. We measured radiation exposure with the seven dosimetry badges which were worn by the surgeon in each group (total of 28 badges). Twenty-four procedures were measured in each group. Cumulative dose and dose rates were compared between groups. RESULTS: Fluoroscopic radiation is received by the operator in real-time for approximately 50% (half) of the operation time. Thyroid protectors and lead aprons can block radiation almost completely. The largest dose was received in the chest irrespective of beam directions. The lowest level of radiation were received when X-ray tube was away from the surgeon and beneath the bed (dose rate of head, neck, chest, abdomen and knee : 0.2986, 0.2828, 0.9711, 0.8977, 0.8168 mSv, respectively). The radiation differences between each group were approximately 2.7-10 folds. CONCLUSION: When fluoroscopic guided-KP is performed, the X-Ray tube should be positioned on the opposite side of the operator and below the table, otherwise the received radiation to the surgeon's body would be 2.7-10 times higher than such condition.