ArticlePM & R : the journal of injury, function, and rehabilitation2018
Comparing Electrical Stimulation With and Without Ultrasound Guidance for Phenol Neurolysis to the Musculocutaneous Nerve.
Article in PM & R : the journal of injury, function, and rehabilitation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 20 citations in OpenAlex.
- Ultrasound-Guided Alcohol Neurolysis for Poststroke Upper Limb Spasticity to Facilitate Arteriovenous Fistula Creation in Hemodialysis: A Case Report.Archives of rehabilitation research and clinical translation · 2026Article
- Phenol neurolysis in people with spinal cord injury: a descriptive study.Spinal cord series and cases · 2022Article
- Comparison of Ultrasound and Electrical Stimulation Guidance for Onabotulinum Toxin-A Injections: A Randomized Crossover Study.Movement disorders clinical practice · 2022Article
- A Novel Approach to New-Onset Hemiplegic Shoulder Pain With Decreased Range of Motion Using Targeted Diagnostic Nerve Blocks: The ViVe Algorithm.Frontiers in neurology · 2021Article
- Novel Conservative Approach to High Surgical Risk Frail Proximal Femur Fractures.Case reports in orthopedics · 2020Article
- Cryoneurotomy as a Percutaneous Mini-invasive Therapy for the Treatment of the Spastic Limb: Case Presentation, Review of the Literature, and Proposed Approach for Use.Archives of rehabilitation research and clinical translation · 2019Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundUltrasound guidance is increasingly being used for neurolytic procedures that have traditionally been done with electrical stimulation (e-stim) guidance alone. Ultrasound visualization with e-stim-guided neurolysis can potentially allow adjustments in injection protocols that will reduce the volume of neurolytic agent needed to achieve clinical improvement.
objectiveThis study compared e-stim only to e-stim with ultrasound guidance in phenol neurolysis of the musculocutaneous nerve (MCN) for elbow flexor spasticity. We also evaluated the ultrasound appearance of the MCN in this population.
designRetrospective review.
settingUniversity hospital outpatient clinic.
participantsAdults (N = 167) receiving phenol neurolysis to the MCN for treatment of elbow flexor spasticity between 1997 and 2014 and adult control subjects.
methodsFor each phenol injection of the MCN, the method of guidance, volume of phenol injected, technical success, improved range of motion at the elbow postinjection, adverse effects, reason for termination of injections, and details of concomitant botulinum toxin injection were recorded. The ultrasound appearance of the MCN, including nerve cross-sectional area and shape, were recorded and compared between groups.
main outcome measuresThe volume of phenol injected and MCN cross-sectional area and shape as demonstrated by ultrasound.
resultsThe addition of ultrasound to e-stim-guided phenol neurolysis was associated with lower doses of phenol when compared to e-stim guidance alone (2.31 mL versus 3.69 mL, P < .001). With subsequent injections, the dose of phenol increased with e-stim guidance (P < .001), but not with e-stim and ultrasound guidance (P = .95). Both methods of guidance had high technical success, improved ROM at elbow postinjection, and low rates of adverse events. In comparing the ultrasound appearance of the MCN in patients with spasticity to that of normal controls, there was no difference in the cross-sectional area of the nerve, but there was more variability in shape.
conclusionsCombined e-stim and ultrasound guidance during phenol neurolysis to the MCN allows a smaller volume of phenol to be used for equal effect, both at initial and repeat injection. The MCN shape was more variable in individuals with spasticity; this should be recognized so as to successfully locate the nerve to perform neurolysis. LEVEL OF EVIDENCE: IV.
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