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[脊髓前侧柱切断术治疗疼痛病症]

[Cordotomy in the treatment of pain conditions].

作者信息

Ivanović S, Slavik E, Spaić M, Antić B, Samardzić M, Rasulić L

机构信息

Institut za neurohirurgiju KCS.

出版信息

Acta Chir Iugosl. 2004;51(4):49-51. doi: 10.2298/aci0404049i.

Abstract

During the time interval from January 1978 to January 2003, total of 128 chordotomy procedures have been done due to cancer's pain at the Institute of neurosurgery in Clinical Centre of Serbia. That pain has been mostly of uncontrolled intensity and it was resistant on applieed conservative treatment. Bilateral chordotomy has been performed in 6 patients only in exceptional cases when fixed paraplegia has proved; unilateral chordotomy has been performed in 122 cases. Bilateral chordotomy is much more dangerous than unilateral one because of greater posibility of appearance of motor deficits, sphincteral disturbances or subsequent formed pain. This procedure has several negative aspects. Firstly, it is an opened surgical intervention in general anesthesia and therefore, there is no communication with patient. We had a habit to perform DREZ surgery rather than chordotomy when ever it has been indicated. In 80.1% of all cases, the successfulness of surgery has been marked as excellent, in 15.2% of all cases, it has been marked as good, and in 4.7% of all cases, bad outcome has been detected. The rate of complication was 4.4%.

摘要

在1978年1月至2003年1月期间,塞尔维亚临床中心神经外科研究所因癌症疼痛共进行了128例脊髓前侧柱切断术。那种疼痛大多强度无法控制,且对所采用的保守治疗有抵抗性。仅在证实出现固定性截瘫的特殊情况下,对6例患者实施了双侧脊髓前侧柱切断术;单侧脊髓前侧柱切断术实施了122例。由于出现运动功能缺损、括约肌功能障碍或随后形成疼痛的可能性更大,双侧脊髓前侧柱切断术比单侧手术危险得多。该手术有几个负面因素。首先,它是在全身麻醉下进行的开放性外科手术,因此无法与患者交流。只要有指征,我们习惯进行脊髓背根入髓区(DREZ)手术而非脊髓前侧柱切断术。在所有病例中,80.1%的手术成功率被标记为优秀,15.2%被标记为良好,4.7%的病例检测到不良结果。并发症发生率为4.4%。

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