Comparing Electrical Stimulation With and Without Ultrasound Guidance for Phenol Neurolysis to the Musculocutaneous Nerve
| Autor: | Jessica Berry, Martha Matsumoto, Herbie Yung, Mary E. Matsumoto, Michael C. Munin |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Elbow Population Physical Therapy Sports Therapy and Rehabilitation Article Musculocutaneous nerve 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Humans Medicine Outpatient clinic Spasticity education Neurolysis Retrospective Studies Ultrasonography education.field_of_study Phenol business.industry Rehabilitation Ultrasound Nerve Block Middle Aged Sclerosing Solutions Electric Stimulation Surgery Treatment Outcome medicine.anatomical_structure Neurology Muscle Spasticity Musculocutaneous Nerve Anesthesia Female Neurology (clinical) medicine.symptom business Range of motion 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | PM&R. 10:357-364 |
| ISSN: | 1934-1482 |
| Popis: | BACKGROUND: Ultrasound guidance is increasingly being used for neurolytic procedures that have traditionally been done with electrical stimulation (e-stim) guidance alone. Ultrasound visualization with e-stim guided neurolysis can potentially allow adjustments in injection protocols that will reduce the volume of neurolytic agent needed to achieve clinical improvement. OBJECTIVE: This study compared e-stim only to e-stim with ultrasound guidance in phenol neurolysis of the musculocutaneous nerve (MCN) for elbow flexor spasticity. We also evaluated the ultrasound appearance of the MCN in this population. DESIGN: Retrospective review SETTING: University hospital outpatient clinic PARTICIPANTS: Adults (N=167) receiving phenol neurolysis to the MCN for treatment of elbow flexor spasticity between 1997 to 2014 and adult control subjects. METHODS: For each phenol injection of the MCN, method of guidance, volume of phenol injected, technical success, improved range of motion at the elbow post-injection, adverse effects, reason for termination of injections and details of concomitant botulinum toxin injection were recorded. Ultrasound appearance of the MCN, including nerve cross-sectional area and shape were recorded and compared between groups. MAIN OUTCOME MEASURES: Volume of phenol injected and MCN cross-sectional area and shape as demonstrated by ultrasound RESULTS: The addition of ultrasound to e-stim guided phenol neurolysis was associated with lower doses of phenol when compared to e-stim guidance alone (2.31 mL vs 3.69 mL, p |
| Databáze: | OpenAIRE |
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