CT-guided Blocks and Neuroablation of the Ganglion Impar (Walther) in Perineal Pain: Anatomy, Technique, Safety, and Efficacy
OBJECTIVEAn alternate approach to the ganglion impar was chosen to minimize the risk of adverse events. Efficacy of the procedure was evaluated. METHODSCharts and computed tomography (CT)-scans of patients who underwent block and neuroablation of the ganglion impar (Walther) between 2003 and 2007 we...
Gespeichert in:
| Veröffentlicht in: | The Clinical journal of pain 2009-09, Vol.25 (7), p.570-576 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 576 |
|---|---|
| container_issue | 7 |
| container_start_page | 570 |
| container_title | The Clinical journal of pain |
| container_volume | 25 |
| creator | Agarwal-Kozlowski, Kamayni Lorke, Dietrich E Habermann, Christian R am Esch, Jochen Schulte Beck, Helge |
| description | OBJECTIVEAn alternate approach to the ganglion impar was chosen to minimize the risk of adverse events. Efficacy of the procedure was evaluated.
METHODSCharts and computed tomography (CT)-scans of patients who underwent block and neuroablation of the ganglion impar (Walther) between 2003 and 2007 were systematically reviewed with respect to adverse events and efficacy by rating pain intensity. A total of 76 blocks were performed, 48 of them being diagnostic blocks and 28 neuroablations. Chemical destruction was performed with ethanol, if pain recurred despite injection of local anesthetic.
RESULTSInterventional pain therapy was performed in 43 patients (age64.6±12.4 y, median 49.5 y, range36 to 86 y, male/female27/16) presenting with perineal pain of unknown origin (n=15), carcinoma of the prostate (n=8), colorectal carcinoma (n=7), postsurgery of thrombosis of perineal veins (n=3), postherpetic neuralgia (n=4), malformation of the spinal cord (n=2), vaginal protrusion (n=2), failed back surgery syndrome (n=1), and ablation of testis (n=1). CT-guided puncture was not associated with any adverse events and resulted in a reduction of numeric rating scale values from 8.2±1.6 to 2.2±1.6 (P |
| doi_str_mv | 10.1097/AJP.0b013e3181a5f5c7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67591648</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>67591648</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3293-7d312da6d8ee34079f70f67722a978b48d3ad548e0787e56c9a102a70fb218be3</originalsourceid><addsrcrecordid>eNpdkEFv1DAQhSMEokvhHyDkCwikpoztJLa5LatSiipYiUUco4kz6Zo6yWInqvbAf8errgAxPoz89M2b0cuy5xzOORj1dvlpfQ4NcEmSa45lV1r1IFvwUlZ5WYB5mC1AFSbXUKiT7EmMPwB4KTQ8zk64qYxQRi2yX6tNfjO7llr23o_2NjIcWvaZ5jBi43Fy48DGjk1bYpc43PjD_6rfYWCvv6NPcnjD3MDWFNxA6Nka3fCOLQecxn5_xjZkt4P7OdMZ-4odTUk6-F90nbNo90-zRx36SM-O_TT79uFis_qYX3-5vFotr3MrhZG5aiUXLVatJpIFKNMp6CqlhECjdFPoVmJbFppAaUVlZQ1yEJigRnDdkDzNXt377sKYjolT3btoyXscaJxjXanS8KrQCSzuQRvGGAN19S64HsO-5lAfYq9T7PX_saexF0f_uemp_Tt0zDkBL48ARou-CzhYF_9w6UpVGfPP_rvRTxTirZ_vKNRbOmRdQypRgs4FgEkPID9IUv4GWFGa0Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>67591648</pqid></control><display><type>article</type><title>CT-guided Blocks and Neuroablation of the Ganglion Impar (Walther) in Perineal Pain: Anatomy, Technique, Safety, and Efficacy</title><source>Journals@Ovid Ovid Autoload</source><source>MEDLINE</source><creator>Agarwal-Kozlowski, Kamayni ; Lorke, Dietrich E ; Habermann, Christian R ; am Esch, Jochen Schulte ; Beck, Helge</creator><creatorcontrib>Agarwal-Kozlowski, Kamayni ; Lorke, Dietrich E ; Habermann, Christian R ; am Esch, Jochen Schulte ; Beck, Helge</creatorcontrib><description>OBJECTIVEAn alternate approach to the ganglion impar was chosen to minimize the risk of adverse events. Efficacy of the procedure was evaluated.
METHODSCharts and computed tomography (CT)-scans of patients who underwent block and neuroablation of the ganglion impar (Walther) between 2003 and 2007 were systematically reviewed with respect to adverse events and efficacy by rating pain intensity. A total of 76 blocks were performed, 48 of them being diagnostic blocks and 28 neuroablations. Chemical destruction was performed with ethanol, if pain recurred despite injection of local anesthetic.
RESULTSInterventional pain therapy was performed in 43 patients (age64.6±12.4 y, median 49.5 y, range36 to 86 y, male/female27/16) presenting with perineal pain of unknown origin (n=15), carcinoma of the prostate (n=8), colorectal carcinoma (n=7), postsurgery of thrombosis of perineal veins (n=3), postherpetic neuralgia (n=4), malformation of the spinal cord (n=2), vaginal protrusion (n=2), failed back surgery syndrome (n=1), and ablation of testis (n=1). CT-guided puncture was not associated with any adverse events and resulted in a reduction of numeric rating scale values from 8.2±1.6 to 2.2±1.6 (P<0.0001, 95% confidence interval 0.5) immediately at discharge and to 2.2±1.4 (P<0.0001, 95% confidence interval 0.4) at 4 months on follow up.
DISCUSSIONCT-guided block and neuroablation of the ganglion impar (Walther) results in a significant reduction of pain scores and carries virtually no hazards.</description><identifier>ISSN: 0749-8047</identifier><identifier>EISSN: 1536-5409</identifier><identifier>DOI: 10.1097/AJP.0b013e3181a5f5c7</identifier><identifier>PMID: 19692797</identifier><identifier>CODEN: CJPAEU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anatomy ; Biological and medical sciences ; Central nervous system ; Female ; Fundamental and applied biological sciences. Psychology ; Ganglia, Sympathetic - injuries ; Ganglia, Sympathetic - surgery ; Humans ; Male ; Medical sciences ; Middle Aged ; Nerve Block - methods ; Neuralgia - diagnostic imaging ; Neuralgia - etiology ; Neuralgia - pathology ; Neuralgia - surgery ; Neurology ; Pain Measurement - methods ; Pelvic Pain - diagnostic imaging ; Pelvic Pain - pathology ; Pelvic Pain - surgery ; Retrospective Studies ; Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors ; Tomography, X-Ray Computed - methods ; Vertebrates: nervous system and sense organs</subject><ispartof>The Clinical journal of pain, 2009-09, Vol.25 (7), p.570-576</ispartof><rights>2009 Lippincott Williams & Wilkins, Inc.</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3293-7d312da6d8ee34079f70f67722a978b48d3ad548e0787e56c9a102a70fb218be3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21876998$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19692797$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Agarwal-Kozlowski, Kamayni</creatorcontrib><creatorcontrib>Lorke, Dietrich E</creatorcontrib><creatorcontrib>Habermann, Christian R</creatorcontrib><creatorcontrib>am Esch, Jochen Schulte</creatorcontrib><creatorcontrib>Beck, Helge</creatorcontrib><title>CT-guided Blocks and Neuroablation of the Ganglion Impar (Walther) in Perineal Pain: Anatomy, Technique, Safety, and Efficacy</title><title>The Clinical journal of pain</title><addtitle>Clin J Pain</addtitle><description>OBJECTIVEAn alternate approach to the ganglion impar was chosen to minimize the risk of adverse events. Efficacy of the procedure was evaluated.
METHODSCharts and computed tomography (CT)-scans of patients who underwent block and neuroablation of the ganglion impar (Walther) between 2003 and 2007 were systematically reviewed with respect to adverse events and efficacy by rating pain intensity. A total of 76 blocks were performed, 48 of them being diagnostic blocks and 28 neuroablations. Chemical destruction was performed with ethanol, if pain recurred despite injection of local anesthetic.
RESULTSInterventional pain therapy was performed in 43 patients (age64.6±12.4 y, median 49.5 y, range36 to 86 y, male/female27/16) presenting with perineal pain of unknown origin (n=15), carcinoma of the prostate (n=8), colorectal carcinoma (n=7), postsurgery of thrombosis of perineal veins (n=3), postherpetic neuralgia (n=4), malformation of the spinal cord (n=2), vaginal protrusion (n=2), failed back surgery syndrome (n=1), and ablation of testis (n=1). CT-guided puncture was not associated with any adverse events and resulted in a reduction of numeric rating scale values from 8.2±1.6 to 2.2±1.6 (P<0.0001, 95% confidence interval 0.5) immediately at discharge and to 2.2±1.4 (P<0.0001, 95% confidence interval 0.4) at 4 months on follow up.
DISCUSSIONCT-guided block and neuroablation of the ganglion impar (Walther) results in a significant reduction of pain scores and carries virtually no hazards.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anatomy</subject><subject>Biological and medical sciences</subject><subject>Central nervous system</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Ganglia, Sympathetic - injuries</subject><subject>Ganglia, Sympathetic - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nerve Block - methods</subject><subject>Neuralgia - diagnostic imaging</subject><subject>Neuralgia - etiology</subject><subject>Neuralgia - pathology</subject><subject>Neuralgia - surgery</subject><subject>Neurology</subject><subject>Pain Measurement - methods</subject><subject>Pelvic Pain - diagnostic imaging</subject><subject>Pelvic Pain - pathology</subject><subject>Pelvic Pain - surgery</subject><subject>Retrospective Studies</subject><subject>Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Vertebrates: nervous system and sense organs</subject><issn>0749-8047</issn><issn>1536-5409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkEFv1DAQhSMEokvhHyDkCwikpoztJLa5LatSiipYiUUco4kz6Zo6yWInqvbAf8errgAxPoz89M2b0cuy5xzOORj1dvlpfQ4NcEmSa45lV1r1IFvwUlZ5WYB5mC1AFSbXUKiT7EmMPwB4KTQ8zk64qYxQRi2yX6tNfjO7llr23o_2NjIcWvaZ5jBi43Fy48DGjk1bYpc43PjD_6rfYWCvv6NPcnjD3MDWFNxA6Nka3fCOLQecxn5_xjZkt4P7OdMZ-4odTUk6-F90nbNo90-zRx36SM-O_TT79uFis_qYX3-5vFotr3MrhZG5aiUXLVatJpIFKNMp6CqlhECjdFPoVmJbFppAaUVlZQ1yEJigRnDdkDzNXt377sKYjolT3btoyXscaJxjXanS8KrQCSzuQRvGGAN19S64HsO-5lAfYq9T7PX_saexF0f_uemp_Tt0zDkBL48ARou-CzhYF_9w6UpVGfPP_rvRTxTirZ_vKNRbOmRdQypRgs4FgEkPID9IUv4GWFGa0Q</recordid><startdate>200909</startdate><enddate>200909</enddate><creator>Agarwal-Kozlowski, Kamayni</creator><creator>Lorke, Dietrich E</creator><creator>Habermann, Christian R</creator><creator>am Esch, Jochen Schulte</creator><creator>Beck, Helge</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200909</creationdate><title>CT-guided Blocks and Neuroablation of the Ganglion Impar (Walther) in Perineal Pain: Anatomy, Technique, Safety, and Efficacy</title><author>Agarwal-Kozlowski, Kamayni ; Lorke, Dietrich E ; Habermann, Christian R ; am Esch, Jochen Schulte ; Beck, Helge</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3293-7d312da6d8ee34079f70f67722a978b48d3ad548e0787e56c9a102a70fb218be3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anatomy</topic><topic>Biological and medical sciences</topic><topic>Central nervous system</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Ganglia, Sympathetic - injuries</topic><topic>Ganglia, Sympathetic - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nerve Block - methods</topic><topic>Neuralgia - diagnostic imaging</topic><topic>Neuralgia - etiology</topic><topic>Neuralgia - pathology</topic><topic>Neuralgia - surgery</topic><topic>Neurology</topic><topic>Pain Measurement - methods</topic><topic>Pelvic Pain - diagnostic imaging</topic><topic>Pelvic Pain - pathology</topic><topic>Pelvic Pain - surgery</topic><topic>Retrospective Studies</topic><topic>Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Vertebrates: nervous system and sense organs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Agarwal-Kozlowski, Kamayni</creatorcontrib><creatorcontrib>Lorke, Dietrich E</creatorcontrib><creatorcontrib>Habermann, Christian R</creatorcontrib><creatorcontrib>am Esch, Jochen Schulte</creatorcontrib><creatorcontrib>Beck, Helge</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Clinical journal of pain</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Agarwal-Kozlowski, Kamayni</au><au>Lorke, Dietrich E</au><au>Habermann, Christian R</au><au>am Esch, Jochen Schulte</au><au>Beck, Helge</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>CT-guided Blocks and Neuroablation of the Ganglion Impar (Walther) in Perineal Pain: Anatomy, Technique, Safety, and Efficacy</atitle><jtitle>The Clinical journal of pain</jtitle><addtitle>Clin J Pain</addtitle><date>2009-09</date><risdate>2009</risdate><volume>25</volume><issue>7</issue><spage>570</spage><epage>576</epage><pages>570-576</pages><issn>0749-8047</issn><eissn>1536-5409</eissn><coden>CJPAEU</coden><abstract>OBJECTIVEAn alternate approach to the ganglion impar was chosen to minimize the risk of adverse events. Efficacy of the procedure was evaluated.
METHODSCharts and computed tomography (CT)-scans of patients who underwent block and neuroablation of the ganglion impar (Walther) between 2003 and 2007 were systematically reviewed with respect to adverse events and efficacy by rating pain intensity. A total of 76 blocks were performed, 48 of them being diagnostic blocks and 28 neuroablations. Chemical destruction was performed with ethanol, if pain recurred despite injection of local anesthetic.
RESULTSInterventional pain therapy was performed in 43 patients (age64.6±12.4 y, median 49.5 y, range36 to 86 y, male/female27/16) presenting with perineal pain of unknown origin (n=15), carcinoma of the prostate (n=8), colorectal carcinoma (n=7), postsurgery of thrombosis of perineal veins (n=3), postherpetic neuralgia (n=4), malformation of the spinal cord (n=2), vaginal protrusion (n=2), failed back surgery syndrome (n=1), and ablation of testis (n=1). CT-guided puncture was not associated with any adverse events and resulted in a reduction of numeric rating scale values from 8.2±1.6 to 2.2±1.6 (P<0.0001, 95% confidence interval 0.5) immediately at discharge and to 2.2±1.4 (P<0.0001, 95% confidence interval 0.4) at 4 months on follow up.
DISCUSSIONCT-guided block and neuroablation of the ganglion impar (Walther) results in a significant reduction of pain scores and carries virtually no hazards.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>19692797</pmid><doi>10.1097/AJP.0b013e3181a5f5c7</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0749-8047 |
| ispartof | The Clinical journal of pain, 2009-09, Vol.25 (7), p.570-576 |
| issn | 0749-8047 1536-5409 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_67591648 |
| source | Journals@Ovid Ovid Autoload; MEDLINE |
| subjects | Adult Aged Aged, 80 and over Anatomy Biological and medical sciences Central nervous system Female Fundamental and applied biological sciences. Psychology Ganglia, Sympathetic - injuries Ganglia, Sympathetic - surgery Humans Male Medical sciences Middle Aged Nerve Block - methods Neuralgia - diagnostic imaging Neuralgia - etiology Neuralgia - pathology Neuralgia - surgery Neurology Pain Measurement - methods Pelvic Pain - diagnostic imaging Pelvic Pain - pathology Pelvic Pain - surgery Retrospective Studies Somesthesis and somesthetic pathways (proprioception, exteroception, nociception) interoception electrolocation. Sensory receptors Tomography, X-Ray Computed - methods Vertebrates: nervous system and sense organs |
| title | CT-guided Blocks and Neuroablation of the Ganglion Impar (Walther) in Perineal Pain: Anatomy, Technique, Safety, and Efficacy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T13%3A30%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=CT-guided%20Blocks%20and%20Neuroablation%20of%20the%20Ganglion%20Impar%20(Walther)%20in%20Perineal%20Pain:%20Anatomy,%20Technique,%20Safety,%20and%20Efficacy&rft.jtitle=The%20Clinical%20journal%20of%20pain&rft.au=Agarwal-Kozlowski,%20Kamayni&rft.date=2009-09&rft.volume=25&rft.issue=7&rft.spage=570&rft.epage=576&rft.pages=570-576&rft.issn=0749-8047&rft.eissn=1536-5409&rft.coden=CJPAEU&rft_id=info:doi/10.1097/AJP.0b013e3181a5f5c7&rft_dat=%3Cproquest_cross%3E67591648%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=67591648&rft_id=info:pmid/19692797&rfr_iscdi=true |