Phenol neurolysis in people with spinal cord injury: a descriptive study

• Published in: Spinal cord series and cases 2022-12, Vol.8 (1), p.90-90, Article 90
• Main Authors: Korupolu, Radha, Malik, Aila, Pemberton, Erin, Stampas, Argyrios, Li, Sheng
• Format: Article
• Language: English
• Subjects: 692/308/409; 692/699/375/1824; Anatomy; Biomedical and Life Sciences; Biomedicine; Human Physiology; Humans; Neurochemistry; Neuropsychology; Neurosciences; Phenol - therapeutic use; Phenols; Spasticity; Spinal cord injuries; Spinal Cord Injuries - complications; Ultrasonic imaging
• ISSN: 2058-6124; 2058-6124
• DOI: 10.1038/s41394-022-00556-0

Study design Descriptive study. Objectives The study’s main objective was to describe the common targets of phenol neurolysis and review the safety and efficacy of the dose used for this spasticity management procedure in people with spinal cord injury (SCI). Setting An acute rehabilitation hospital. Methods Data from people with SCI who underwent phenol neurolysis procedures for spasticity management between April 2017 and August 2018 were included in this study. We collected demographics and phenol neurolysis procedure-related information. Results A total of 66 people with SCI and spasticity underwent phenol neurolysis of 303 nerves over 102 encounters. During these encounters, 97% of procedures were performed using both electrical stimulation and ultrasound guidance. The median (IQR) total volume of 6% aqueous phenol used per encounter was 4.0 (2.0–6.0) ml with a median (IQR) of 1.5 (1.0–2.3) ml per nerve. The most frequent target was the obturator nerve (33%), followed by the pectoral nerves (23%). Immediate post-phenol neurolysis improvement or reduction in spasticity was reported for 92% of all documented encounters. There was no documentation of any post-procedure-related adverse events in this cohort during this specified time frame. Conclusions Our findings suggest that phenol neurolysis can be safely used to manage spasticity in people with SCI under combined electrical stimulation and ultrasound guidance. Further research is required to assess the procedure’s safety, efficacy, and cost-effectiveness on patient-reported outcomes compared to other spasticity interventions.