MIPSI or Minimally invasive pain and spine interventions is a broad term which encompasses all the Non-invasive and minimally invasive interventions done by the interventional spine and pain physicians for myriad of conditions right from Musculo-skeletal disorders like back pain, neck pain, knee pain etc.
What is Coeliac Plexus and where is it situated?
Coeliac plexus also known as Solar plexus consists of a Coeliac ganglia with a network of interconnecting fibers. It is formed in part by the Greater and Lesser splanchnic nerves of both sides and fibers from the anterior and posterior vagal trunks.
The function of the celiac plexus is to receive both parasympathetic and sympathetic inputs from the vagus (CN X) and splanchnic nerves, and to convey their respective postsynaptic outputs to the abdominal viscera.
Coeliac plexus is located in the abdomen at the level of L1 vertebra, near where the Coeliac trunk, Superior Mesenteric artery and Renal arteries branch from the abdominal aorta.
What is the procedure of Coeliac Plexus Radiofrequency neurectomy?
Coeliac Plexus Radiofrequency neurectomy is an advanced procedure which involves the precise placement of the Radiofrequency needles at the level of L1 vertebra at the antero- lateral aspects from both sides, identification of the plexus with the help of sensory and motor stimulation and then its targeted ablation using Radiofrequency current.
Whole procedure is done under local anaesthesia with some mild sedation.
What are the Indications of Coeliac Plexus neurectomy?
- Cancer of pancreas, stomach, Gall bladder and biliary tree
- Chronic Pancreatitis
- Intractable abdominal pain
How Coeliac Plexus neurectomy MIPSI helps relief pain?
Coeliac Plexus Radiofrequency neurectomy mainly acts by 2 mechanisms:
Peripheral Wallerian degeneration of the nerve: Due to the application of Radiofrequency currents , the friction between the various tissue molecules generate thermal energy which burns the nerves and brings about what is called as conduction block. So these nerves stop conducting pain signals from the affected site towards the brain where pain stimulus is actually processed and patient feels immediate relief from pain.
Central neuromodulation: Chronic pain has a component of Central Sensitization where in there is amplification of the pain signals in the brain and patients experience pain even in the absence of any movements or painful stimulus. With application of Radiofrequency ablation there is modulation in these central neural circuitries and the central sensitization is abolished.
How early the beneficial effects can be seen?
Patient can start appreciating the effect of the procedure within 3-4 days and maximal effect is achieved over a period of 3-4 weeks.
How many times this procedure has to be repeated?
The effect of this procedure can last from about 6 months to few years, after which this procedure has to be repeated. During this pain free period patient becomes drug free and thus escapes from the side effects of these medications which occur due to prolonged use of the drugs.
Will I require hospitalization for this procedure?
Yes. Patient generally is hospitalized for a period of 24 hours post-procedure for observation.
To see how this procedure is done, click the below link