PROBLEMS RELATED TO DORSAL-ROOT ENTRY ZONE LESIONS

被引:20
作者
KUMAGAI, Y
SHIMOJI, K
HONMA, T
UCHIYAMA, S
ISHIJIMA, B
HOKARI, T
FUJIOKA, H
FUKUDA, S
OHAMA, E
机构
[1] NIIGATA UNIV,SCH MED,DEPT ANESTHESIOL,1-757 ASAHI MACHI,NIIGATA 951,JAPAN
[2] NIIGATA UNIV,SCH MED,DEPT ORTHOPED,NIIGATA 951,JAPAN
[3] NIIGATA UNIV,BRAIN RES RES INST,DEPT PATHOL,NIIGATA 951,JAPAN
[4] TOKYO METROPOLITAN NEUROL HOSP,DEPT NEUROSURG,TOKYO,JAPAN
关键词
DORSAL ROOT ENTRY ZONE (DREZ) LESION; PAIN; HISTOLOGY; OBJECTIVE PAIN RELIEF SCORE;
D O I
10.1007/BF01406361
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Several clinical problems related to the dorsal root entry zone lesions (DREZLs) in 15 patients with chronic pain are presented and discussed in terms of ratings of pain relief following surgery. development of sensory or motor weakness and postmortem histologies. Subjective pain relief exceeding 70% was achieved at around 2 weeks after the operations in most patients (13/15). and then decreased in some to 30 from 70% in the follow-up observations. Our new "objective" pain relief score was tested in these patients. A significant positive correlation between subjective pain relief and our objective pain relief scale was found, but some discrepancies between them were also found during the follow-up. Sensory loss. motor weakness, paraesthesia and a new pain were found as complications in 12, 7, 4 and 6 patients, respectively. Postmortem histological findings of the spinal cord in two patients with systemic lupus erythematosus and uterine cancer, who received bilateral DREZLs twice and bilateral DREZLs plus commissural myelotomy, respectively, indicate that care should be taken to avoid extension Of the coagulation beyond the dorsal horn.
引用
收藏
页码:71 / 78
页数:8
相关论文
共 23 条
[1]  
ELIAS Z, 1988, APPL NEUROPHYSIOL, V51, P255
[2]  
FRIEDMAN AH, 1988, APPL NEUROPHYSIOL, V51, P164
[3]   LIMITED MYELOTOMY FOR THE TREATMENT OF INTRACTABLE CANCER PAIN [J].
GILDENBERG, PL ;
HIRSHBERG, RM .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1984, 47 (01) :94-96
[4]  
IACONO RP, 1988, APPL NEUROPHYSIOL, V51, P225
[5]  
ISHIJIMA B, 1988, APPL NEUROPHYSIOL, V50, P175
[6]   SOMATOSENSORY FUNCTION FOLLOWING DORSAL-ROOT ENTRY ZONE LESIONS IN PATIENTS WITH NEUROGENIC PAIN OR SPASTICITY [J].
JEANMONOD, D ;
SINDOU, M .
JOURNAL OF NEUROSURGERY, 1991, 74 (06) :916-932
[7]   COMPARISON OF LASER AND RADIOFREQUENCY DORSAL-ROOT ENTRY ZONE LESIONS IN CATS [J].
LEVY, WJ ;
GALLO, C ;
WATTS, C .
NEUROSURGERY, 1985, 16 (03) :327-330
[8]   PHANTOM LIMBS AND THE CONCEPT OF A NEUROMATRIX [J].
MELZACK, R .
TRENDS IN NEUROSCIENCES, 1990, 13 (03) :88-92
[9]  
Nashold B.S., 1976, ADV PAIN RES THER, VVolume 1, P959
[10]   DORSAL ROOT ENTRY ZONE LESIONS FOR PAIN RELIEF [J].
NASHOLD, BS ;
OSTDAHL, RH .
JOURNAL OF NEUROSURGERY, 1979, 51 (01) :59-69