Transsacrococcygeal approach to ganglion impar block for treatment of chronic coccygodynia after spinal arachnoid cyst removal
نویسندگان
چکیده
BACKGROUND Coccygodynia is a pain in the region of the coccyx that radiates to the sacral, perineal area. The cause of the pain is often unknown. Coccygodynia is diagnosed through the patient's past history, a physical examination, and dynamic radiographic study, but the injection of local anesthetics or a diagnostic nerve blockade are needed to distinguish between somatic, neuropathic, and combined pain. Ganglion impar is a single retroperitoneal structure made of both paravertebral sympathetic ganglions. Although there are no standard guidelines for the treatment of coccygodynia, ganglion impar blockade is one of the effective options for treatment. METHODS Here, we report a 42-year-old female patient presenting with severe pain in the coccygeal area after spinal arachnoid cyst removal. RESULTS Treatment involved neurolysis with absolute alcohol on the ganglion impar through the transsacrococcygeal junction. Pain was relieved without any complications. CONCLUSION Our case report offers the ganglion impar blockade using the transsacrococcygeal approach with absolute alcohol can improve intractable coccydynia.
منابع مشابه
Coccyx Pain Treatment & Management: Approach Considerations, Coccygectomy, Ganglion Impar Sympathetic Nerve Blocks
Older techniques for performing the ganglion impar block involved approaching the anterior sacrococcygeal region by using a curved needle inserted below the distal coccygeal tip. The older technique required a larger-diameter and longerlength needle (in particular, the longer length of that needle being inserted into the patient) compared with the current (transsacrococcygeal) approach, which u...
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BACKGROUND The ganglion impar is the first pelvic ganglion of the efferent sympathetic trunk that relays pelvic and perineal nociceptive messages and therefore constitutes a therapeutic target. OBJECTIVE The objective of this single-center study was to evaluate the effectiveness of 3 repeated ganglion impar blocks in patients with chronic pelvic and perineal pain on intention-to-treat. STUD...
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1. Loev MA, Varklet VL, Wilsey BL, Ferrante FM. Cryoablation: A novel approach to neurolysis of the ganglion impar. Anesthesiology 1998;88:1391-1393. 2. Plancarte R, Velazquez R, Patt RB. Neurolytic blocks of sympathetic axis. In: Patt R, ed. Cancer Pain. Philadelphia: JB Lippincott Publishers; 1993:417-420. 3. Wemm KJ, Saberski L. Modified approach to block the ganglion impar (ganglion of Walt...
متن کاملTranssacrococcygeal approach to ganglion impar: radiofrequency application for the treatment of chronic intractable coccydynia
OBJECTIVE Coccydynia is defined as pain in the coccygeal region. Among the many causes of coccydynia, the most common cause is trauma as a result of falling on the buttocks, repetitive microtrauma, or childbirth. Several methods are currently used for the treatment of coccydynia, including nonsteroidal anti-inflammatory drugs, intrarectal manipulation, epidural injections, ganglion impar blocks...
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Sacrococcygeal dislocation is a rare injury. The ganglion impar (also called the ganglion of Walther) is a single, small solitary, sympathetic ganglion located in the retrorectal space, anterior to the sacrococcygeal joint or coccyx. It provides the nociceptive and sympathetic supply to the perineal structure. Ganglion impar blockade is not a routinely used anesthetic and analgesic procedure in...
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