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Thursday, February 4, 2010
Wednesday, February 3, 2010
CRYOSURGERY AND CRYOANALGESIC SYSTEM
The CryoPac Cryoanalgesic System
INTRODUCTION
Cryoanalgesia is a specialized technique for providing long-term pain relief for various podiatric conditions. People have recognized the value of cold for analgesia, for thousands of years. Modern Cryoanalgesia as we know it today was developed in the early 1960's. This technique is superior to other methods of peripheral nerve destruction (e.g., alcohol injections, phenol applications, or surgical resection) because it is not followed by neuritis or neuralgia.
There are few options for successful relief from painful foot conditions. Surgical resection of the nerves often leads to recurrent nerve growths called neuromas. These neuromas are often more painful than the original problem. Narcotics do not treat nerve pain, but rather only "mask" the pain.
The application of cold to tissues creates a conduction block. This is similar to the effect of local anesthetics, but the effect is long lasting. Long-term pain relief from nerve freezing occurs because the formation of the ice crystal disrupts the sensory component of the nerve structure.
PROCEDURE
Cryosurgery is performed in the office of Dr. Jonathan M. Kletz. This minimally invasive technique takes 15 minutes to perform from start to finish. The painful area is infiltrated with a local anesthetic, so that the cryoprobe can be introduced without discomfort. A tiny puncture is made through the skin. Next, a small blunt instrument called a trocar is placed through the punctured site to create a portal for the cryoprobe to be introduced. The probe is inserted through the puncture site and the Cryopac is set for a 3 minute freeze cycle, followed by a 30 second defrost, then another 3 minute freeze. The probe is then removed. An antibiotic ointment is placed over the puncture site with a sterile dressing applied. Sutures are not necessary due to the small size of the puncture. The dressing may be removed within 24 hours and a shower is then permitted. The puncture site is to be covered with a small amount of antibiotic and a band-aid. Postoperative discomfort is minimal. It is suggested that you decrease your normal level of activity over the first 48 hours. Your next scheduled visit will be within 3-7 days.
PLANTAR FASCITIS
Some of the most common ailments I see in my practice are plantar fascitis, heel spurs and generalized heel pain. Over the years many different treatments have been developed to try to eliminate these painful conditions. Cortisone injections, strappings, orthotics, and oral anti-inflammatories have had limited success. Even the newer surgical procedures such as endoscopic plantar fasciotomies, and ESWT (shock wave therapy) have not shown dramatic results. The Cryopac has been able to achieve results far superior to those conventional methods. The Cryopac will allow for the best possible treatment for any patient who suffers from heel pain.
NEUROMAS
Morton's neuromas are another common podiatric condition. Symptons present as pain commonly between the third and fourth metatarsals that causes numbness, tingling, burning, or shooting pains into the involved toes. Patients often experience the sensation of an electric shock in the ball of the foot. Pressure from ill-fitting shoes appears to exacerbate the symptoms. The term neuroma actually refers to a benign nerve tumor in the foot. Standard treatments such as cortisone injections and surgery have led to less than optimal results. The Cryopac is a more effective treatment option for these painful nerve conditions. It has also proven effective for patients who have undergone previous surgical treatment with recurrence of pain.
OTHER INDICATIONS FOR CRYOSURGERY
In my continuing quest to bring my patients the latest advances in treatment options for a wide variety of ailments, I have found that the Cryopac can be used to treat many other foot problems. Nerve entrapments in other parts of the foot can be treated effectively with the Cryopac Management of diabetic peripheral neuropathy and painful osteoarthritis has shown promising results. Soft tissue tumors, such as plantar fibromas, are other problems that can be treated with this technology.
INSURANCE COVERAGE
Most insurance plans provide varying degrees of coverage for this procedure.
INTRODUCTION
Cryoanalgesia is a specialized technique for providing long-term pain relief for various podiatric conditions. People have recognized the value of cold for analgesia, for thousands of years. Modern Cryoanalgesia as we know it today was developed in the early 1960's. This technique is superior to other methods of peripheral nerve destruction (e.g., alcohol injections, phenol applications, or surgical resection) because it is not followed by neuritis or neuralgia.
There are few options for successful relief from painful foot conditions. Surgical resection of the nerves often leads to recurrent nerve growths called neuromas. These neuromas are often more painful than the original problem. Narcotics do not treat nerve pain, but rather only "mask" the pain.
The application of cold to tissues creates a conduction block. This is similar to the effect of local anesthetics, but the effect is long lasting. Long-term pain relief from nerve freezing occurs because the formation of the ice crystal disrupts the sensory component of the nerve structure.
PROCEDURE
Cryosurgery is performed in the office of Dr. Jonathan M. Kletz. This minimally invasive technique takes 15 minutes to perform from start to finish. The painful area is infiltrated with a local anesthetic, so that the cryoprobe can be introduced without discomfort. A tiny puncture is made through the skin. Next, a small blunt instrument called a trocar is placed through the punctured site to create a portal for the cryoprobe to be introduced. The probe is inserted through the puncture site and the Cryopac is set for a 3 minute freeze cycle, followed by a 30 second defrost, then another 3 minute freeze. The probe is then removed. An antibiotic ointment is placed over the puncture site with a sterile dressing applied. Sutures are not necessary due to the small size of the puncture. The dressing may be removed within 24 hours and a shower is then permitted. The puncture site is to be covered with a small amount of antibiotic and a band-aid. Postoperative discomfort is minimal. It is suggested that you decrease your normal level of activity over the first 48 hours. Your next scheduled visit will be within 3-7 days.
PLANTAR FASCITIS
Some of the most common ailments I see in my practice are plantar fascitis, heel spurs and generalized heel pain. Over the years many different treatments have been developed to try to eliminate these painful conditions. Cortisone injections, strappings, orthotics, and oral anti-inflammatories have had limited success. Even the newer surgical procedures such as endoscopic plantar fasciotomies, and ESWT (shock wave therapy) have not shown dramatic results. The Cryopac has been able to achieve results far superior to those conventional methods. The Cryopac will allow for the best possible treatment for any patient who suffers from heel pain.
NEUROMAS
Morton's neuromas are another common podiatric condition. Symptons present as pain commonly between the third and fourth metatarsals that causes numbness, tingling, burning, or shooting pains into the involved toes. Patients often experience the sensation of an electric shock in the ball of the foot. Pressure from ill-fitting shoes appears to exacerbate the symptoms. The term neuroma actually refers to a benign nerve tumor in the foot. Standard treatments such as cortisone injections and surgery have led to less than optimal results. The Cryopac is a more effective treatment option for these painful nerve conditions. It has also proven effective for patients who have undergone previous surgical treatment with recurrence of pain.
OTHER INDICATIONS FOR CRYOSURGERY
In my continuing quest to bring my patients the latest advances in treatment options for a wide variety of ailments, I have found that the Cryopac can be used to treat many other foot problems. Nerve entrapments in other parts of the foot can be treated effectively with the Cryopac Management of diabetic peripheral neuropathy and painful osteoarthritis has shown promising results. Soft tissue tumors, such as plantar fibromas, are other problems that can be treated with this technology.
INSURANCE COVERAGE
Most insurance plans provide varying degrees of coverage for this procedure.
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