Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Palliative Rhizotomy: A Novel Technical Application

Abstract

BACKGROUND Spastic cerebral palsy is caused by an insult to the developing brain. Various medical and surgical procedures are used to reduce tone. OBJECTIVE To describe a novel method of magnetic resonance-guided laser interstitial thermal ablation for palliative rhizotomy. METHODS Patients treated at a single institution with percutaneous rhizotomy using magnetic resonance–guided laser interstitial thermal therapy were identified. Preoperative and postoperative Modified Ashworth Scale scores were collected as well as procedural information. RESULTS Two male children (7.8 and 19 yr, respectively) with spastic quadriparesis were treated using this technique. Neither patient experienced surgical or perioperative complications, and both were discharged from the hospital within 48 h. Each of them demonstrated improvement in his Modified Ashworth Scale score with no need for retreatment for spasticity at last follow-up. CONCLUSION These 2 cases illustrate a novel technique for treating spasticity in the setting of cerebral palsy. Further study of this technique in additional patients, and comparison with traditional methods of surgical tone reduction, are warranted.

Minimally invasive delivery of peptides to the spinal cord for behavior modulation

“…Indeed, optic fiber-based probes are under clinical trials to monitor spinal cord hemodynamics in large animals, such as pigs (24). Clinicians have also adapted spinal laser interstitial thermal therapy (LITT) for treating tumors in the spinal cord in human patients (25, 26). Compared to FUS, the Opto-BSCB method provides an effective and safe tool for delivering a wide range of molecules locally.…”