{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:56:35Z","timestamp":1786125395938,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T00:00:00Z","timestamp":1576627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Percutaneous glycerol rhizotomy (PGR) is a well-described treatment for trigeminal neuralgia; however, the technique in using surface landmarks and fluoroscopy has not drastically changed since being first introduced. In this paper, we describe a protocol for PGR using computed tomography (CT) guidance based on an experience of over 7 yr and 200 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To introduce an approach for PGR using CT guidance and, in doing so, demonstrate possible benefits over the traditional fluoroscopic technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a standard CT scanner, patients are placed supine with head in extension. Barium paste and a CT scout image are used to identify and plan a trajectory to the foramen ovale. A laser localization system built into the CT scanner helps to guide placement of the spinal needle into the foramen ovale. The needle position in the foramen is confirmed with a short-sequence CT scan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CT-guided PGR provides multiple benefits over standard fluoroscopy, including improved visualization of the skull base and significant reduction in radiation exposure to the surgeon and staff. Side benefits include improved procedure efficiency, definitive imaging evidence of correct needle placement, and potentially increased patient safety. We have had no significant complications in over 200 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>CT-guided PGR is a useful technique for treating trigeminal neuralgia based on better imaging of the skull base, better efficiency of the procedure, and elimination of radiation exposure for the surgeon and staff compared to traditional fluoroscopic based techniques.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opz400","type":"journal-article","created":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T03:38:32Z","timestamp":1576640312000},"page":"E117-E121","source":"Crossref","is-referenced-by-count":7,"title":["Computed Tomography Guidance for Percutaneous Glycerol Rhizotomy for Trigeminal Neuralgia"],"prefix":"10.1227","volume":"19","author":[{"given":"Bradley T","family":"Schmidt","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conrad D","family":"Pun","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendell B","family":"Lake","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7727-7185","authenticated-orcid":false,"given":"Daniel K","family":"Resnick","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,8]]},"reference":[{"key":"bib1-20231031","first-page":"582","article-title":"Ueber die intracranielle injectionsbehandlung der trigeminus-neuralgie","volume":"10","author":"Hartel","year":"1914","journal-title":"Medizinische Klinik"},{"issue":"Suppl 1","key":"bib2-20231031","first-page":"25","article-title":"A review of percutaneous treatments for trigeminal neuralgia","volume":"10","author":"Cheng","year":"2014","journal-title":"Neurosurgery"},{"issue":"2","key":"bib3-20231031","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1227\/NEU.0b013e318233a85f","article-title":"Comparative evaluation of percutaneous retrogasserian glycerol rhizolysis and radiofrequency thermocoagulation techniques in the management of trigeminal 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hartel technique for percutaneous treatment of trigeminal neuralgia","volume":"110","author":"Iwanaga","year":"2018","journal-title":"World Neurosurg"},{"issue":"10","key":"bib11-20231031","first-page":"e345","article-title":"Comparing radiation dose from conventional fluoroscopy to intraoperative cone beam CT (O-arm) during percutaneous lesioning procedures of the gasserian ganglion","volume":"7","author":"Desai","year":"2015","journal-title":"Cureus"},{"issue":"1","key":"bib12-20231031","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S1042-3680(18)30338-3","article-title":"Percutaneous retrogasserian glycerol rhizotomy. 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