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Percutaneous retrogasserian glycerol rhizotomy for trigeminal neuralgia: an alternative technique

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Abstract Background: One of the challenges faced by the modern-day NHS is workplace shortages, and experienced radiographers for intra-operative neurosurgical imaging is one such scenario. We describe our method for… Click to show full abstract

Abstract Background: One of the challenges faced by the modern-day NHS is workplace shortages, and experienced radiographers for intra-operative neurosurgical imaging is one such scenario. We describe our method for Percutaneous Retrogasserian Glycerol Rhizotomy (PRGR) using frameless neuronavigation which can be used effectively in such scenarios. Method: Stealth neuronavigation is used for needle placement within the foramen ovale and injection of glycerol, under sedation. Results: In our experience of ten procedures, it is accurate, safe and effective. Good results were obtained on all occasions. It can be repeated as often as necessary using the same Stealth® CT scan and reduces exposure for staff and patients, where repeated injections are required. Conclusion: This simple modification of PRGR technique is effective and safe provided the surgeon has previous experience in undertaking this procedure.

Keywords: technique; glycerol rhizotomy; glycerol; retrogasserian glycerol; rhizotomy trigeminal; percutaneous retrogasserian

Journal Title: British Journal of Neurosurgery
Year Published: 2018

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