E-ISSN 1305-3612
Interventional Radiology - Original Article
Computed tomography guided cryoablation for post thoracotomy pain syndrome: a retrospective analysis
1 Department of Radiology, University of Missouri Columbia, One Hospital Drive, Columbia, United States;University of Missouri Columbia School of Medicine, One Hospital Drive, Columbia, United States  
2 -Department of Radiology, University of Missouri Columbia, One Hospital Drive, Columbia, United States  
3 Division for Cardiothoracic Surgery, University of Missouri Columbia, One Hospital Drive, Columbia, United States  
4 Department of Radiology, Division of Cardiothoracic Imaging, University of Texas Health Science Center, Texas, United States  
Diagn Interv Radiol ; : -

Abstract

 

PURPOSE: Post thoracotomy pain syndrome is a common condition affecting up to 50% of post thoracotomy patients.  However, percutaneous computed tomography guided intercostal nerve cryoablation may provide symptomatic benefit in chronic and/or refractory cases.

 

METHODS: A retrospective review of our institution’s comprehensive case log from October 2017 to September 2018 for patients who underwent cryoablation was analyzed. Thirteen patients with post thoracotomy pain syndrome, refractory to medical management, were treated with computed tomography guided intercostal nerve cryoablation.  Most patients had treatment of the intercostal nerve at the level of their thoracotomy scar, two levels above and below. The safety and technical success of this technique and the clinical outcomes of the study population were then retrospectively reviewed.

 

RESULTS: 69% patients experienced significant improvement in their pain symptoms with a median pain improvement score of 3 (range: -1-8) points over a median follow-up of 11 months (range: 2-18.6) months. Complications included pneumothorax in 8% and pseudo-hernia in 23% of patients.

 

CONCLUSION: Computed tomography guided intercostal nerve cryoablation may be an effective technique in the treatment of post thoracotomy pain syndrome and requires further study.

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