New thoracic MBB anatomy

[RoloTomassi]

Based on new locations of articular branches from this dissection by Maus, looks like the articular branches are not always coming off the medial branches, or if they are, are very close to DRG.

Doesn't seem like targeting the MB at the sling would do much--would only hit lateral branch. TP targeting seems more medial than previous models. Pedicle shadow technique seems like it would hit MB but miss articular branches too.

Thoughts?

https://www.sciencedirect.com/science/article/pii/S2772594424000190

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[Ducttape]

to be specific, this is the thoracic innervation on 1 cadaver.

would be reasonable to confirm these findings on other cadavers.

would simplify thoracic RFAs...

 

[pmrmd]

As above 1 cadaver study and pedicle shadow technique is mostly effective, so all we can say is it must be highly variable.

 

[clubdeac]

I use cooled and aim for the most superolateral aspect of the TP. The lesion goes out several mm and may reach that articular branch in your diagram

 

[HyperSonic]

I use cooled and aim for the most superolateral aspect of the TP. The lesion goes out several mm and may reach that articular branch in your diagram

Some thoracic TP could be up to couple centimeters in length. Unlikely cooled RF as good in creating such a big lesion as in charging high fees…

 

[clubdeac]

Some thoracic TP could be up to couple centimeters in length. Unlikely cooled RF as good in creating such a big lesion as in charging high fees…

Fees for the patient are the same but yeah cooled is way over priced for the provider and hospital. I work in the hospital so no skin off my back. Just try and do what’s most effective regardless of cost to hospital

 

[HyperSonic]

Fees for the patient are the same but yeah cooled is way over priced for the provider and hospital. I work in the hospital so no skin off my back. Just try and do what’s most effective regardless of cost to hospital

Lucky you man, I would do the same. Unfortunately we have to count pennies working in private offices…