Studija slučaja
https://doi.org/10.21857/yl4okf86x9
Intercostal cryoneurolysis for the management of chronic intercostal neuralgia after vertebral column fracture – a case report
Ana Jozepović
orcid.org/0000-0003-2724-4243
; University Hospital Centre Zagreb, Department of Anesthesiology, ICU and Pain Therapy, Zagreb, Croatia
*
Anja Mandarić
; University Hospital Centre Zagreb, Department of Anesthesiology, ICU and Pain Therapy, Zagreb, Croatia
Zrinka Orešković
; University Hospital Centre Zagreb, Department of Anesthesiology, ICU and Pain Therapy, Zagreb, Croatia
Diana Cvitković
; University Hospital Centre Zagreb, Department of Anesthesiology, ICU and Pain Therapy, Zagreb, Croatia
Sanja Jakovina-Blažeković
; University Hospital Centre Zagreb, Department of Anesthesiology, ICU and Pain Therapy, Zagreb, Croatia
Sandra Morović
; Arsano Medical Group
* Dopisni autor.
Sažetak
Cryoneurolysis is a minimally invasive, non-surgical, non-pharmacological method used to treat acute and chronic pain. This technique involves the application of low temperatures to reversibly interrupt the conduction of sensory nerves, thereby blocking the sensation of pain. Cryoneurolysis is commonly used in the treatment of neuropathic pain, postoperative pain, chronic pain syndromes, and injury-related pain. This technique is safe and highly effective, and the procedure is typically performed under fluoroscopic or ultrasound guidance, allowing for precise placement of the cryoapplicator on the affected nerve. However, it is important to carefully assess the indications and contraindications to ensure maximum effectiveness and safety of the procedure. We report a case of a 22-year-old patient who suffered from a traumatic vertical fracture of T8 at the junction of the pedicle and the transverse process on the right side, confirmed by an MRI. He experienced severe pain for nearly four years. Despite physical therapy and extensive use of NSAIDs, the pain persisted. Two years later, the patient was diagnosed with Thoracic Syndrome, and continued pain management with opioids, which was ineffective. Four years after injury, a diagnostic intercostal nerve block (T7-T9) with ropivacaine and dexamethasone provided temporary pain relief. After exhibiting the positive response, the patient underwent cryoneurolysis of the intercostal nerves. The procedure was performed under ultrasound guidance, involved freezing the nerves at T7- T9, and effectively blocking pain transmission. Following the procedure, the patient experienced immediate relief, with no pain reported during a 2-week follow-up, leading to the discontinuation of analgesic medications.
Ključne riječi
cryoneurolysis; intercostal nerves; pain management; intercostal neuralgia
Hrčak ID:
326032
URI
Datum izdavanja:
20.12.2024.
Posjeta: 0 *