Thermal probe

The Thermal probe is a medical aid for sclerotherapy of peripheral nerves. During this process, the tip of the probe is heated in a controlled manner. The procedure is usually carried out on an outpatient basis under sterile conditions; the main indication is chronic pain in the spine.

What is a thermal probe?

Thermoprobe therapy is a minimally invasive surgical procedure that is established in pain therapy, orthopedics and neurosurgery. The procedure itself only takes a few minutes and is carried out by experienced doctors without intraoperative X-ray control. A targeted, reliable and, above all, low-complication denervation without fluoroscopy is not possible. Precise placement of the probe requires precision work and a visual inspection using X-ray fluoroscopy (C-arm) is required on several levels.

The thermal probe works with heat to sclerotise peripheral nerve fibers in the lumbar spine, which can be responsible for triggering chronic pain and tension in the muscles. Over time, however, the sclerosed nerve cords can regenerate and lead to painful tension, pain or restricted mobility.

This is why it is not uncommon for chronic pain patients to have the procedure carried out several times at intervals of a few months. If the pain does not subside after the treatment with the thermal probe, then the peripheral nerves in the spine are not the cause of the pain. The medical procedure that is performed on the spine using the thermal probe is called thermocoagulation. It describes a desolation of nerves due to the action of heat. Since protein denatures during this process, it is also called coagulation.

Shapes, types & types

Medical thermoprobes are basically of the same design, because they are all designed to sclerose the finest nerve endings on the spine. There are thermal probes which are suitable for multiple use and are therefore reusable. For this purpose, the tip of the probe, mostly made of steel, is sterilized before any further use. Sterilization as a process to destroy all germs and bacteria must strictly follow the manufacturer's specifications.

There are also single-use probes that are discarded after a single use on a patient. Practices in which a large number of treatments with the thermal probe are carried out daily usually use single-use probes. Multiple probes are significantly more expensive to purchase and are rarely used today. Which type of probe a practitioner prefers is individual and also depends on the indication.

Structure & functionality

Thermal probes for the safe and harmless lesion of peripheral nerves usually have a total length of 50 millimeters. Each probe has a suitable generator and a special adapter cable that connects the probe to the generator. The doctor can use a regulator to precisely set the required heat at the tip of the thermal probe and modify it precisely during the procedure. Because as soon as a nerve has been obliterated, this leads to a slight decrease in the temperature in the probe tip.

"In the lumbar spine, probe lengths of 80 millimeters and more are required, with the active, heatable probe tip only being 5-10 millimeters long. The duration of the procedure depends on the number of vertebral segments to be treated. Usually in one session Two to three segments (4-6 vertebral joints) are treated, the duration of the procedure is at least 30-45 minutes. Sedation by an anesthetist is not necessary for most patients and would even be a disadvantage, as constant communication should be done with the patient awake. Local anesthesia is usually sufficient. When used correctly by an experienced specialist, the duration of action is significantly longer in the majority of patients. One and a half years or more are not uncommon. " (Source: Dr. med.Thomas Beckert, orthopaedie-chiemsee.de)

The actual treatment happens when the heated tip briefly and specifically touches a peripheral nerve selected by the doctor. The protein of the nerve tip coagulates immediately, this process is called coagulation. The nerve is thus rendered harmless and pain information can no longer be passed on through the treated nerve.

The tip of a thermal probe is usually heated to a minimum of 70 ° C, better 80 ° -85 ° C. This temperature is not felt as pain, however, because local anesthesia is applied before heating. In a therapy session, individual nerve cords can also be obliterated several times.

You can find your medication here

Medical & health benefits

The medical and health benefits of tube sclerotherapy are rated as extremely high in chronic pain patients. Treatment with the thermal probe is often the end of a whole series of conservative pain relief measures. Because the thermal probe treatment is minimally invasive, it is considered to be particularly low-risk and gentle.

Treatment is performed in the prone position, usually in the presence of an anesthetist, who is responsible for sedating the patient during the procedure. General anesthesia is not required and is only justified in medically justified exceptional cases.

The medical benefit is also based on the fact that the use of the thermal probe can in many cases avoid a risky stiffening operation on segments of the spine. The main cause of chronic pain in the spine are signs of wear and tear such as osteoarthritis, which can also lead to the degeneration of intervertebral discs. Treatment with the thermal probe does not directly eliminate the cause of the pain, for example osteoarthritis, but rather interrupts the transmission of pain by sclerosing the nerves.

For most patients, this leads to a significant reduction in pain after the procedure, if not to complete freedom from pain. If the nerve fibers that cause pain are known precisely through previous diagnostics, the thermal probe can also be used with imaging. In this case, the additional administration of a contrast agent would be necessary for a computer tomography as an X-ray control.

Patients must be monitored after the procedure, but can then be discharged home immediately. Extensive rest on the day of the operation is also not necessary, so that normal everyday activities can usually be pursued without restriction.

Although treatment with the heat probe for thermocoagulation is very often carried out in older people, it is basically suitable for every age group. Patients with chronic complaints in particular benefit from the procedure.

In addition to age-related wear and tear on the small vertebral joints, the thermal probe can also be used to successfully treat bony changes in the cervical or thoracic spine, for example as a result of accidents or previous operations.