Percutaneous dorsal root ganglion lysis with phenol for the treatment of pain associated with thoracic compression fracture.
BACKGROUND
Symptomatic thoracic compression fracture is one of the most common causes of back pain in elderly. Although vertebroplasty is widely utilized in patients when conservative treatment fails, we introduced an alternative percutaneous technique for the treatment of thoracic compression pain.


METHODS
This in a retrospective study. The analysis was performed on 28 consecutive patients who underwent undergoing percutaneous dorsal root ganglion lysis with phenol for the treatment of pain associated with thoracic compression fracture. An acceptable treatment outcome was operationally defined as a pain intensity numerical rating scale (NRS) score of 3 or lower or EQ-5D index of 0.672 or higher. The primary outcome was pain relief and acceptable treatment outcome at 1 day, 1 week, 1 month, and 1 year.


RESULTS
Of the 28 cases treated with our procedures, the change in mean NRS score between baseline and one day was -2.5 (95 % CI -1.6 ~ -3.4, p < 0.001), between baseline and one week was -4.7 (-4.1 to -5.3, p < 0.001), between baseline and one month was -5.8 (-5.2 to -6.5, p < 0.001), and between baseline and one year was -6.3 (-5.6 to -7.1, p < 0.001). An acceptable treatment outcome was 14 % one day after the procedure, 46 % at one week, 72 % at one month, and 84 % at one year. Complication rate was 3.6 %.


CONCLUSIONS
For thoracic compression fracture patients, percutaneous dorsal root ganglion lysis with phenol is an effective, and safe alternative treatment method worth considering. Pain relief is fast and persists for one year.
Department of Neurosurgery, Chang Gung Memorial Hospital, 6 section West, Chia Pu Road, Pu Tz City, Chia, Yi 613, Taiwan.
Chun-Hsien
CH
Lin
Ming-Hsueh
MH
Lee
Martin Hsiu-Chu
MH
Lin
Ting-Chung
TC
Wang
Wan-chun
WC
Cheng
Yuan-Hsiung
YH
Tsai
Chu-Hsiang
CH
Hsu
Jen-Tsung
JT
Yang
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050815:Fractures, Compression / Q000150:complications / Q000601:surgery*; D005727:Ganglia, Spinal / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D019800:Phenol; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000295:instrumentation / Q000379:methods
D019800:Phenol