This is the second post, in our new series, that recognizes Myoguide application, used to manage spasticity, in scientific publications
We do try to keep track of the many references citing Myoguide use as an essential part of research based publications. This is part of our ongoing surveillance needed and our responsibility maintaining our medical device licences. The following series will feature these articles, to help illustrate the various benefits of using Myoguide in practice and for research applications.
There have been many journal articles written within the realm of Botulinum Toxin applications that cite “Myoguide” use as part of the studies. This article hails out of:
Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School and The NeuroRecovery Research Center at TIRR
The objective of this research was to present practice patterns for phenol neurolysis procedures conducted for spasticity management. Myoguide ESTIM was used and served to provide support for delivering phenol neurolysis.
A retrospective review of 185 persons with spasticity who underwent phenol neurolysis procedures (n = 293) at an academic rehabilitation hospital and clinic. Patient demographics, concomitant spasticity treatments, and procedure relevant information were collected.
Phenol neurolysis was used to manage 77% of the patients reviewed. Musculoskeletal diagnoses included spastic hemiplegia, or paresis (51.3%); Tetraplegia (38.4%); and paraplegia (9.2%). At the time of phenol neurolysis most of the patients received concomitant pharma treatments for spasticity. Both ESTIM and Ultrasound were used in 69.3% of the cases. Ultrasound only, was used for the remainder.
The most commonly injected nerves included: Obturator N. (35.8%) and Sciatic N. (27%).
Post-phenol neurolysis assessment was recorded in 54.9% of encounters, of which 84.5% reported subjective benefit. Post-treatment adverse events, including pain (4%), swelling/ inflammation (2.7%), dysesthesia (0.7%), and hypotension (0.7%).
The conclusions were that Phenol neurolysis is currently used to reduce spasticity for various functional goals, including preventing contractures and improving gait. Depending on the pattern of spasticity displayed, numerous peripheral nerves in the upper and lower extremities can be targeted for treatment with phenol neurolysis. Further research into its role in spasticity management, including studies exploring its cost-effectiveness and pharmacological and side-effects compared with other treatment options are needed.
We posted a blog article on “Chemodenervation & Neurolytic Procedures” that covered motor point chemodenervation or chemical neurolytic procedures. We observed that the procedures required low current stimulation location in the order of 0.2-0.5 mA, depending on the stimulation pulse width. The Myoguide™ EMG/ESTIM BoNT injection guidance system does accommodate both EMG and STIM guidance procedures. Myoguide’s stimulator section is capable of delivering stimulation in both 0.1mA and 1.0mA steps.
Please have a look at the article and the appropriate reference materials for more details.
Jay KARRI, MD, MPH, Manuel F. MAS, MD, Gerard E. FRANCISCO, MD and Sheng LI, MD, PhD, PRACTICE PATTERNS FOR SPASTICITY MANAGEMENT WITH PHENOL NEUROLYSIS From the Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston (UTHealth) McGovernMedical School and The NeuroRecovery Research Center at TIRR Memorial Hermann, Houston, TX, USAJ Rehabil Med 2017; 49: 482–488
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