“In this procedure, we use imaging to insert an electrode next to the affected nerve,” said Hou, a musculoskeletal specialist with SNHRC.
“A high frequency electrical current then runs through the electrode tip, heating and coagulating the nerve that’s causing discomfort.”
Image guidance is also used for a procedure called kyphoplasty, which treats compression fractures of the vertebrae, often seen in patients with osteoporosis. A balloon is inserted through a catheter into the damaged vertebra to create a cavity that is filled with a cement-like material that hardens, restoring the structure of the vertebra and providing pain relief. CMC says it has expanded its kyphoplasty program and now conducts both inpatient and outpatient procedures.
“Until now, the common belief has been that severe back pain required surgery,” Hou said.
“While everyone’s case is unique, there are many minimally invasive and outpatient procedures that can provide significant relief and, in some cases, repair back problems.”
Tumor killers
In many image-guided procedures, a team of specialists uses either CT or ultrasound technology to insert a needle or a catheter and deliver isolated treatment to an area of the body. Renvyle, an interventional radiologist, is using such procedures to treat cancer. Two methods, microwave ablation and Yttrium 90, are new to CMC and the surrounding area.
Similar to RF nerve ablation to treat back pain, microwave ablation uses microwaves to kill tumors. The procedure is an alternative to surgery for tumors on the liver, kidney, lung or bones.
“This is an outpatient procedure,” Renvyle said. “Before, a patient would have been hospitalized to have a tumor surgically removed. Now they can come in for ablation and be home that same afternoon. It’s a tremendous comfort for those who are dealing with all the aspects of cancer treatment.”
Yttrium-90, or Y-90 radiotherapy, is another cancer treatment offering hope to patients, mostly those with liver cancer, who have exhausted other options.
Y-90 is a dose of nuclear medicine that is delivered through imaging guidance directly to a tumor. The Y-90 can shrink tumors, relieve pain and potentially extend life for those who are no longer benefitting from chemotherapy.
“What’s particularly exciting about Y-90,” Renvyle said, “is that patients who have become ineligible for survival treatment can get back on the list with effective Y-90 treatment.”
Migraine symptoms
Migraine sufferers can also look to radiology to treat their debilitating, multi-symptom headaches. A sphenopalatine ganglion block directly treats the SPG nerves, located in the sinus cavity and the source of much headache pain. In a 20-minute procedure, a radiologist places an applicator through the nasal passage to deliver lidocaine to the SPG nerves, numbing them for six weeks or more.
The treatment, which was introduced at CMC earlier this year, is effective in treating migraines, tension and cluster headaches.
“One of our first patients almost cancelled their appointment because they were so nauseated and in so much pain (from their migraine) that they were reluctant to come in,” recalled Marcy Rushford, who directs imaging services at CMC. “They managed to get here and within an hour of arriving they were leaving completely symptom-free.”
—Information for this report was supplied by Catholic Medical Center.