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Neurolytic Injections for the Treatment of Pain in the Rehabilitation Patient

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Abstract

Neurolysis is an underutilized technique of providing prolonged, and at times permanent, interruption of select neural pathways involved in nociception in cases of chronic, intractable pain. While malignancy-related pain is the most notable and recognizable indication for neurolytic block, any chronic, intractable pain condition that is resistant to more conservative analgesic approaches can be considered to be an indication for neurolysis. This is provided that the pain has a clearly defined etiology and can be reliably assessed using local anesthetic diagnostic blocks prior to proceeding to this irreversible modality. Neural interruption can be undertaken using physical, chemical, and thermal methodologies. The focus of this chapter is to describe techniques of using chemical agents as neurolytics for select indications of moderate-to-severe pain of the head and face, the thorax and abdomen, and of the spine and extremities in the rehabilitation patient.

Keywords

  • Intractable pain
  • Neurolysis
  • Neurolytic agents
  • Alcohol
  • Phenol
  • Wallerian degeneration
  • Radiofrequency ablation
  • Cryoablation

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Correspondence to Kenneth D. Candido M.D. .

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D. Candido, K., England, B. (2017). Neurolytic Injections for the Treatment of Pain in the Rehabilitation Patient. In: Carayannopoulos DO, MPH, A. (eds) Comprehensive Pain Management in the Rehabilitation Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-16784-8_39

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  • DOI: https://doi.org/10.1007/978-3-319-16784-8_39

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