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首页> 外文期刊>Neurosurgery >Treatment of refractory pain after brachial plexus avulsion with dorsal root entry zone lesions.
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Treatment of refractory pain after brachial plexus avulsion with dorsal root entry zone lesions.

机译：臂丛神经撕脱伴背根进入区病变治疗顽固性疼痛。

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OBJECTIVE: Significant numbers of patients experience intractable pain after brachial plexus root avulsions. Medications and surgical procedures such as amputation of the limb are often not successful in pain treatment. METHODS: Forty-seven patients with intractable pain after traumatic cervical root avulsions were treated with dorsal root entry zone coagulation between 1980 and 1998. The dorsal root entry zone coagulation procedure was performed 4 months to 12 years after the trauma, and patients were monitored for up to 18 years (average follow-up period, 14 yr). RESULTS: Immediately after surgery, 75% of patients experienced significant pain reduction; this value was reduced to 63% during long-term follow-up monitoring. Nine patients experienced major complications, including subdural hematomas (n = 2) and motor weakness of the lower limb (n = 7). Improved coagulation electrodes with thermistors that could produce smaller and more-accurate lesion sizes, which were introduced in 1989, significantly reduced the number of complications. CONCLUSION: Central deafferentation pain that persists and becomes intractable among patients with traumatic cervical root avulsions has been difficult to treat in the past. Long-term follow-up monitoring of patients who underwent the dorsal root entry zone coagulation procedure in the cervical cord indicated that long-lasting satisfactory relief is possible for the majority of individuals, with acceptable morbidity rates.
机译：目的：大量患者臂丛神经根撕脱术后出现顽固性疼痛。诸如肢体截肢之类的药物和外科手术通常在疼痛治疗中并不成功。方法：1980年至1998年间，对47例外伤性颈根部撕脱术后顽固性疼痛的患者进行了背根部区域凝结治疗。在创伤后4个月至12年进行了背根部区域凝结手术，并监测患者的病情。最长18年（平均随访期14年）。结果：手术后立即，75％的患者疼痛明显减轻;在长期随访监测中，该值降低到63％。 9名患者经历了严重并发症，包括硬膜下血肿（n = 2）和下肢运动无力（n = 7）。 1989年推出的改进的带有热敏电阻的凝结电极可产生更小，更准确的病灶，大大减少了并发症的发生。结论：过去，难以治愈的中央性脱除咖啡因的疼痛在患有外伤性宫颈根部撕脱的患者中持续存在并且变得顽固。对接受颈背背根进入区凝血手术的患者进行的长期随访监测表明，对于大多数个体而言，可以实现长期令人满意的缓解，其发病率可以接受。

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