Lesions of spinal and trigeminal dorsal root entry zone for deafferentation pain. Experience of 35 cases.

B Ishijima, K Shimoji, H Shimizu, H Takahashi, I Suzuki
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引用次数: 38

Abstract

Spinal and trigeminal dorsal root entry zone destruction (DREZ-tomy) was performed on 35 patients with deafferentation pain of various types. Overall, satisfactory pain relief was obtained in 65.5% of spinal DREZ-tomy cases in the follow-up observation. The result in the brachial plexus avulsion group was the best (82.4% improved), followed by the limb pain group without root avulsion (50.0%), but the truncal or visceral pain group showed the worst result (33.3%). Two patients with postherpetic trigeminal neuralgia were completely relieved of pain in the average follow-up period of 32 months, while in 2 patients with postrhizotomy facial pain, pain recurred 4 months after the operation in 1, and, in the other, pain in the medial part of the face remained unchanged. Complications were seen in about 60% of the patients, which were, however, all mild, except for 2 cases of death due to gastrointestinal disease.

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脊髓和三叉神经背根进入区损伤引起脱神经传递疼痛。35例经验。
对35例不同类型的脱神经痛患者行脊髓及三叉神经背根进入区破坏术。总体而言,65.5%的脊柱drez切除术患者在随访观察中获得了满意的疼痛缓解。臂丛撕脱组效果最好(改善82.4%),其次是无根撕脱的肢体疼痛组(改善50.0%),而躯干或内脏疼痛组效果最差(改善33.3%)。2例带状疱疹后三叉神经痛患者在平均随访32个月后疼痛完全缓解,2例带状疱疹后面部疼痛患者,1例术后4个月疼痛复发,1例面部内侧疼痛未发生变化。约60%的患者出现并发症,但除2例因胃肠道疾病死亡外,其余均为轻微并发症。
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Proceedings of the 2nd International Symposium on Dorsal Root Entry Zone (DREZ) Lesions. Durham, N.C., April 24-26, 1987. Abnormal physiology of the dorsal horn as related to the deafferentation syndrome. Neurochemistry of the dorsal horn. Investigation on cerebrospinal fluid opioids and neurotransmitters related to spinal cord stimulation. Historical development of neural transplantation.
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