Alívio da dor após bloqueio do gânglio ímpar e ablação por radiofrequência em pacientes com coccigodínia: Uma revisão sistemática

Choudhary, Ranjeet; Kunal, Kishor; Kumar, Dhirendra; Nagaraju, Venishetty; Verma, Shilp

doi:10.1055/s-0041-1735829

Cited by 7 publications

(10 citation statements)

References 29 publications

(97 reference statements)

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“…Найчастіше спостерігається травматична етіологія, наприклад, травма куприка, спричинена падінням назад на тверду поверхню, вивихом куприка чи травмою під час пологів, гіпермобільніс тю або спікулами (ос теофітами) куприка. Інфекція чи пухлини куприка є рідкіснішими причинами [7,8].…”

Section: вступunclassified

“…Дорослі та підлітки частіше страждають на це захворювання. Ожиріння також пов'язане з підвищеним ризиком розвитку КД [8,11].…”

Section: вступunclassified

“…Більшість випадків КД (близько 90%) можна лікувати консервативною терапією (нестероїдні протизапальні засоби (НПЗЗ), модифікація способу сидіння, використання спеціальних куприкових подушок, реабілітація та вправи д ля тазового дна, теплові й холодні компреси, черезшкірна електрична стимуляція нервів, ударно-хвильова терапія, фізіотерапія) [9]. У разі неефективності консервативного лікування можна застосувати прямі ін'єкції навколо куприка (паракокцигіальні блокади), каудальні епідуральні стероїдні ін'єкції або втручання на непарному вузлі (НВ) [6][7][8][9]. В окремих випадках виконують кокцигектомію.…”

Section: вступunclassified

“…В окремих випадках виконують кокцигектомію. З огляду на високу частоту уск ладнень хірургічне втручання розглядають лише тоді, коли інші засоби знеболювання не допомагають [8].…”

Section: вступunclassified

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Minimally Invasive Interventions on Ganglion Impar in Treatment of Patients with Coccygodynia

Romanukha,

Biloshytsky

2024

Ukr Neurosurg J

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Chronic pelvic pain (CPP) is usually treated conservatively, but in patients who do not respond to treatment, ganglion impar (GI) interventions are used as an alternative way to reduce pain. Objective ‒ to study the course of pain syndrome and functional status in patients with coccygodynia (CD) and CPP during the application of minimally invasive interventions on GI. Materials and methods. The analysis of the results of 56 interventions on GI in 50 patients was performed. Inclusion criteria were patients with coccyx pain for ≥3 months aged 23 to 71 years (mean age 47.9±14.8years) who did not respond to conservative treatment methods. 15 (35.7%) of the study participants were male and 27 (64.3%) were female. Interventions were performed on the patients according to five different methods, which were divided into two groups: the first group (n=34) ‒ GI block (GIB) with a local anesthetic and a steroid (patients with CD in whom medical conservative methods of treatment were not effective). The second group (n=14) consisted of persons with recurrent pain syndrome, resistant forms of CD and CPP, including after previously performed steroid injections: n=2 – neurolysis of GI with ethyl alcohol; n=2 – neurolysis of GI by phenol; n=3 – radio frequency modulation of GI; n=7 – radiofrequency ablation of GI. Results. 14.0% of all study participants had post-traumatic CD (history of falling on the coccyx), the vast majority of 86.0% ‒ idiopathic CD. Pain intensity was significantly lower post-intervention compared to baseline VAS mean of 7.6±1.5 cm: 2.5±0.9 cm one-week post-procedure, 1.5±1.9 cm one month, 1.3±1.5 cm three months, 2.1±1.2 cm six months. The average score according to the Karnovsky Scale (KS) before and after the procedure was 73.3±6.3% and 83.9±4.9%, respectively. Conclusions. Interventions on ganglion impar are an effective method of treating patients with coccygodynia of various etiology, which significantly reduce pain according to the VAS scale (p<0.001) and improve the quality of life according to the KS (p<0.001) in dynamics after 1, 3, 6 months. Minimally invasive interventions on ganglion impar make it possible to reduce tissue trauma, to quickly recover for patients after the procedure, and to minimize any complications. In the first and second groups of the study, there was a decrease in the pain on the VAS from 8.0 cm to 2.0 cm (p<0.0001) and from 7.0 cm to 2,7 cm (p<0.001) before and after the procedure, respectively. In the first and second groups of the study, there was an improvement in the indicator of functional status according to the KS from 70% (95% сonfidence interval (CI) 60‒90%) to 90% (95% CI 70‒100%, p<0.0001) and from 70% (95% CI 70‒90%) to 90% (95% CI 80‒100%, p=0.001) before and after the procedure, respectively.

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Section: вступunclassified

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Minimally Invasive Interventions on Ganglion Impar in Treatment of Patients with Coccygodynia

Romanukha,

Biloshytsky

2024

Ukr Neurosurg J

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“…Additionally, steroids further improved GIBs for coccydynia [32]. A systematic review was conducted to determine the efficacy of GIB and RFA (radio frequency ablation) of the ganglion impar in controlling pain in patients with coccydynia; the overall success rate was > 85 % for both modalities [33]. One study reports that GIB may be more effective in cancer-related pain than in pain due to benign causes [34].…”

Section: Interventional Proceduresmentioning

confidence: 99%

Imaging findings and treatment in coccydynia – update of the recent study findings

Sukun,

Cankurtaran,

Agildere

et al. 2023

Rofo

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Background Coccydynia is one of the most overlooked symptoms in clinical practice. The diagnosis and radiologic findings of traumatic coccyx can be more easily detected unless it is delayed and postponed. For idiopathic coccydynia, which accounts for one third of cases, patients present with long-standing pain and multiple physician visits. Method The keywords coccyx, coccydynia, coccygodynia were searched in PubMed, Embase, Scopus databases in the last 5 years. Research articles, reviews and case reports were analyzed. The studies conducted in the last 5 years were presented under the headings of etiology, radiologic assessment, interventional and surgical treatments. Results and Conclusion The first step is dynamic X-ray of the coccyx in standing and sitting position. In this way, morphologic parameters and hypermobility causing idiopathic coccydynia can be evaluated. Morphologic and morphometric features of the coccyx described in previous CT and MR studies have explained the relationship with coccydynia. The key features are as follows: Type II coccyx morphology, subluxation of the intercoccygeal joint, presence of bony spicules. Knowledge of these definitions as well as the differential diagnosis in this anatomical region will help in reaching the correct diagnosis. The treatment of coccydynia is stepwise like the diagnosis. Conservative treatments are initiated first. Manipulations, ganglion impar block, injections, radiofrequency and shock treatments and finally coccygectomy are treatment methods reported. Radiologists should not overlook this region and should be familiar with the coccyx’s morphologic appearance and the sacrococcygeal region’s differential diagnosis. Key points:

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Ganglion Impar Blocks

Ortiz,

Lubrano,

Breidenbach

et al. 2024

Essentials of Interventional Techniques in Managing Chronic Pain

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Alívio da dor após bloqueio do gânglio ímpar e ablação por radiofrequência em pacientes com coccigodínia: Uma revisão sistemática

Cited by 7 publications

References 29 publications

Minimally Invasive Interventions on Ganglion Impar in Treatment of Patients with Coccygodynia

Minimally Invasive Interventions on Ganglion Impar in Treatment of Patients with Coccygodynia

Imaging findings and treatment in coccydynia – update of the recent study findings

Ganglion Impar Blocks

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