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. 2022 Sep 28;58(10):1359.
doi: 10.3390/medicina58101359.

Navigation Guidance for Percutaneous Splanchnic Nerve Radiofrequency Neurolysis: Preliminary Results

Stavros Grigoriadis  1 , Dimitrios Filippiadis  1 , Vasiliki Stamatopoulou  1 , Efthimia Alexopoulou  1 , Nikolaos Kelekis  1 , Alexis Kelekis  1
Affiliations

Navigation Guidance for Percutaneous Splanchnic Nerve Radiofrequency Neurolysis: Preliminary Results

Stavros Grigoriadis et al. Medicina (Kaunas). .

Abstract

Background and Objectives: To describe preliminary results upon the application of the "Cube Navigation System" (CNS) for computed tomography (CT)-guided splanchnic nerve radiofrequency neurolysis. Materials and Methods: CT-guided splanchnic nerve neurolysis was performed in five patients; in all cases, neurolysis was performed under CT guidance using the CNS. The mean patient age was 71.6 years (range 54-81 years; male/female: 5/0). Technical success, parameters of the neurolysis session and complications were evaluated. Technical success was defined as a needle position on the defined target. Session parameters included procedure time and number of scans. The CIRSE reporting system was used for complications' classification and grading. Results: Technical success was obtained in all cases; in 1/5 patients, a slight correction in needle orientation was necessary. Mean procedure time was 12.4 min (range 8-19 min); an average of four CT scans was recorded in the five neurolysis sessions. There were no complications or material failures reported in the present study. Conclusions: Preliminary results of the present study show that computed tomography (CT)-guided splanchnic nerve radiofrequency neurolysis using the CNS is an accurate and time-efficient percutaneous procedure. More prospective and comparative studies with larger patient samples are necessary for verification of this system as well as for drawing broader conclusions.

Keywords: computed tomography; navigation; neurolysis; pain.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The CNS system consisting of the PC on the right, and software on the left. The software displays the standard MPR views in coronal, sagittal and axial views. Shown here is an example infiltration at the lumbar level. The chosen trajectory of the virtual needle is shown as a highlighted yellow cross-hair marker which can be freely moved. Based on the trajectory of the needle, the corresponding coordinates in the upper-left and lower-right templates are highlighted by the software. The physical puncture needle is then inserted through these holes.
Figure 2
Figure 2
Initial CT scan with target and the cube mounted on the skin.
Figure 3
Figure 3
Planning of the puncture: (A): The yellow line represents the planned puncture path via a virtual needle (markers on the line represent cm). (B): The software calculates the entry (upper plate left) and exit point (lower plate right) and displays green dots at the coordinates to be used for this particular planned line.
Figure 4
Figure 4
Final image prior to treatment: (A): Corrected (MPR) CT image of the cube with the needle in place, showing the whole needle trajectory. At the tip of the needle, there is hyperdense contrast pooling, verifying the correct needle position. (B): Actual image of the needle and electrode in place inside the cube.
See this image and copyright information in PMC

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