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Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Coccygodynia or pain in the coccygeal region is often somatic and in a great percentage associated with a traumatic injury. It has multiple origins and may be multifactorial. We present a case of pelvic pain. A 55-year-old with a diagnosis of coccygodynia, who underwent abdominoperineal resection due to a rectal adenocarcinoma. The patient was treated by blockade and radiofrequency of the impar ganglion. We emphasize the anatomical alterations that can occur after this kind of surgery and the importance of a treatment tailored to each patient and their characteristics. [ABSTRACT FROM AUTHOR]

Radiofrequency is based on an electric field to generate a nerve injury or modulate the nociceptive signal, and it can be monopolar or bipolar, continuous or pulsed. Pulsed modality is used on the dorsal root ganglion for treatment of radicular pain resistant to other treatments, with good results after 3 months. Otherwise, continuous radiofrequency is used for low back pain from facet joint with variable results. In recent years, intracanal pulsed radiofrequency through a catheter has been developed for the treatment of several dorsal root ganglia, especially in canal stenosis and failed back syndrome. The results in these applications are promising. The scientific evidence in all the mentioned areas is weak and more solid and long-term studies are needed. [ABSTRACT FROM AUTHOR]

As the population ages, lumbar pain is more prevalent and grows the interest for low cost and low risk diagnostic methods and therapeutic procedures. Ultrasound improves interventional pain procedures and reduces x-ray exposure. There is insufficient evidence for the clinical value of ultrasound as a diagnostic tool in the management of low back pain and more research is needed to define the role of rehabilitative ultrasound imaging. [ABSTRACT FROM AUTHOR]

Cryoablation is an energy alternative to radiofrequency for ablation of various arrhythmias, where its unique biophysical properties offer a greater safety profile. Since its first use for the surgical treatment of different arrhythmias until its conceptualization in the current technical transcatheter, cryoablation has proven not to be only a safe source of energy, but also an effective source in the long-term. While the radiofrequency has been the energy most used for isolation of pulmonary veins in atrial fibrillation ablation, technological advances in cryoballon have managed to simplify the procedure without sacrificing its effectiveness. Cryoablation has been widely used for arrhythmias located in high-risk locations, such as the ablation of the atrioventricular nodal reentrant tachycardia and septal accessory pathways, due to its theoretical null risk of complete AV block. This review intends to give the clinical applications of the cryothermy through a thorough understanding of their biophysical basis. [ABSTRACT FROM AUTHOR]

Post-amputation pain of the lower limb may occur due to a neuroma of the sciatic nerve, among other causes. We present the case of a 48 year old woman with stump pain, 15 years after the transfemoral amputation of the lower right limb, which prevents her from using the prosthesis. The presence of a sciatic neuroma of 2.2 × 2.2 × 1.5 cm at 8 cm proximal to the stump is diagnosed. An ultrasoundguided, diagnostic-therapeutic test was performed, infiltrating 0.2% ropivacaine and 0.4% triamcinolone in two sessions. Since the patient shows a good response, Pulsed Radiofrequency (PRF) is applied to the neuroma but there is no satisfactory response to the treatment. Therefore, surgical exeresis is considered as a last option as it has shown good results over pain, despite having a high injury recurrence. More studies on the adequate management of stump-neuroma pain are needed since the existent scientific evidence in this regard is scarce. [ABSTRACT FROM AUTHOR]

Catheter-based ablation of isthmus-dependent common atrial flutter results in very high success rates and almost no complications. However, bidirectional conduction block through the isthmus may be challenging in a small percentage of patients regarding the use of high power and high temperature settings during radiofrequency delivery. Anatomical and physiological circumstances may be the reason for such difficulties to achieve bidirectional block at the cavo-tricuspid isthmus. However, in the present case we show edema formation after multiple shots of radiofrequency delivery at the cavo-tricuspid isthmus, which complicates the achievement of bidirectional conduction block. [ABSTRACT FROM AUTHOR]