Balás I, Llumiguano C, Horvath Z, Kovér F, Dóczi T P
Departamento de Neurocirugía, Facultad de Medicina, Universidad de Pecs, Hungría.
Rev Neurol. 2000;31(6):531-3.
Medial thalamotomy is one of the first stereotactic operations to have been used for neurogenic pain, has a low complication rate and no risk of the development of iatrogenic neurogenic pain. It represents selective local relief for all types of pain, without causing somatosensorial deficit.
We did 39 posteromedial thalamotomies in patients with persistent intractable pain due to various disorders. The pain was assessed pre- and postoperatively on the VAS (Visual Analogic Scale).
Half of the patients operated on had relief of pain after thalamotomy. In 84% (n = 39) of our cases this relief occurred on the second day, in 70% (n = 35) after three months, in 63% (n = 27) after six months, in 64% (n = 25) after nine months, in 62% (n = 23) of the patients after 12 months, and in 62% (n = 22) after 24 months. Three patients had temporary complications and one a permanent complication, but this did not make him an invalid.
Posteromedial stereotactic thalamotomy under MR guidance can provide safe, effective treatment for persistent, intractable pain.
内侧丘脑切开术是最早用于治疗神经源性疼痛的立体定向手术之一，并发症发生率低，且不存在医源性神经源性疼痛的风险。它能选择性地局部缓解各种类型的疼痛，而不会导致躯体感觉功能缺损。
我们对因各种疾病导致持续性顽固性疼痛的患者进行了39例后内侧丘脑切开术。术前和术后通过视觉模拟评分法（VAS）对疼痛进行评估。
接受手术的患者中有一半在丘脑切开术后疼痛得到缓解。在我们的病例中，84%（n = 39）的患者在术后第二天疼痛缓解，70%（n = 35）在三个月后缓解，63%（n = 27）在六个月后缓解，64%（n = 25）在九个月后缓解，62%（n = 23）的患者在12个月后缓解，62%（n = 22）在24个月后缓解。3例患者出现了暂时性并发症，1例出现了永久性并发症，但这并未使其成为残疾。
在磁共振引导下进行后内侧立体定向丘脑切开术可为持续性顽固性疼痛提供安全、有效的治疗。
