Single CT-Guided Chemodenervation of the Anterior Scalene Muscle with Botulinum Toxin for Neurogenic Thoracic Outlet Syndrome
| Autor: | Dana K. Christo, Adam J. Carinci, Paul J. Christo, Julie A. Freischlag |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual analogue scale First rib resection medicine.medical_treatment Neurotoxins Pain Injections Intramuscular Young Adult Statistical significance medicine Humans Longitudinal Studies Prospective Studies Botulinum Toxins Type A Muscle Skeletal Prospective cohort study Pain Measurement Thoracic outlet syndrome business.industry General Medicine Middle Aged medicine.disease Botulinum toxin Muscle Denervation Surgery Thoracic Outlet Syndrome Treatment Outcome Anesthesiology and Pain Medicine McGill Pain Questionnaire Anesthesia Nerve block Female Neurology (clinical) Tomography X-Ray Computed business medicine.drug |
| Zdroj: | Pain Medicine. 11:504-511 |
| ISSN: | 1526-4637 1526-2375 |
| DOI: | 10.1111/j.1526-4637.2010.00814.x |
| Popis: | Objective. To examine pain relief in patients with neurogenic thoracic outlet syndrome (NTOS) after a single, low dose injection of botulinum toxin A (Botox) into the anterior scalene muscle (ASM) under computed tomographic (CT) guidance. Design. Prospective longitudinal study. Setting. Academic medical institution. Patients. Patients 18 years of age and older were evaluated for potential scalenectomy and first rib resection using the transaxillary approach at the study institution between 2005 and 2008. All patients had failed physical therapy. A total of 29 procedures on 27 participants were studied. Interventions. A single, 20-unit injection of Botox into the ASM under CT-guidance. Outcome Measures. Short-form McGill Pain Questionnaire (SF-MPQ) prior to and at 1, 2, and 3 months post-Botox toxin injection. Results. There was a decline in pain during the 3 months subsequent to Botox injection as noted by the following components of the SF-MPQ: sensory (P = 0.02), total (P = 0.05), visual analog scale (VAS [P = 0.04]), and present pain intensity (PPI) score (P = 0.06). The proportion of patients reporting more intense pain scores did not return to the pre-intervention level at 3 months post-Botox injection. Conclusion. Patients experienced substantial pain relief in months 1 and 2 following a single Botox injection into the ASM under CT guidance. Significant pain reduction was noted for 3 months after Botox injection with respect to both sensory and VAS scores, and the total and PPI scores approximated statistical significance. After 3 months, patients experienced a 29% decrease in the sensory component of their pain as well as an approximate 15% reduction in their VAS score. A single, CT-guided Botox injection into the ASM may offer an effective, minimally invasive treatment for NTOS. |
| Databáze: | OpenAIRE |
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