Evaluation of Safe Insertion Angles for Spinal Needles and Safe Intensity of the Holmium:YAG Laser during Percutaneous Laser Disc Ablations in Feline Cadavers.

In the context of veterinary medicine, minimally invasive techniques for feline spinal surgery remain underexplored, particularly for percutaneous laser disc ablation (PLDA) when using the Holmium:YAG (Ho:YAG) laser. This study aimed to refine the application of the Ho:YAG laser in PLDA by determining the optimal laser intensity and safe insertion angles for the thoracic and lumbar intervertebral discs (IVDs) in cats. Through utilizing computed tomography (CT) for precise guidance, this research involved a cadaveric study of 10 cats to evaluate the spatial configurations that allow for safe needle insertions and effective laser ablation. Various energy settings of the Ho:YAG laser (20 J, 40 J, and 60 J) were tested to ascertain the balance between adequate disc vaporization and minimal adjacent tissue damage. The results demonstrate that a 40 J setting is the most effective in achieving significant disc decompression without compromising surrounding tissue integrity. Additionally, the CT scans proved crucial in confirming the accuracy of the needle placement and the safety of the laser application angles. This study established that the 40 J setting on the Ho:YAG laser, combined with CT-guided insertion techniques, offers a reliable method for PLDA, thus enhancing the safety and efficacy of feline spinal surgeries.

Use of stellate ganglion block for treatment of recurrent syncope followed by chest pain.

Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery. Stellate ganglion block (SGB) is a nerve block method that is used for treatment of neuropathic pain in the head, neck and upper extremities, especially trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome. SGB can modulate and stabilize the sympathetic nervous system, which prevents it from overexcitation and improves symptoms of syncope. The authors report a patient who was treated for pain and edema of both upper extremities with SGB, then showed improvement in recurrent syncope followed by chest pain and overall quality of life.