Prestor Borut
Department of Neurosurgery, Ljubljana University Medical Center, Ljubljana, Slovenia.
Croat Med J. 2006 Apr;47(2):271-8.
To analyze long-term clinical results of coagulation lesions of the dorsal root entry zone (DREZ) in patients with deafferentation pain due to brachial plexus avulsion and to correlate the pain relief after DREZ coagulation with pain duration before the DREZ coagulation.
Twenty-six patients with intractable deafferentation pain after brachial plexus avulsion lesion were treated for pain at the Department of Neurosurgery. Junctional coagulation lesion was made with bipolar forceps along the DREZ. The patients assessed post-operative analgesic effect using a visual analog scale at 1 week, 1 year, 3 years, and 5 years after the surgery.
The greatest pain relief was reported immediately after the DREZ procedure. Over the 5-year follow-up period, the pain relief effect gradually and significantly decreased. There were no significant differences between the pain relief evaluated at 1 week and after 1 year and between the pain relief evaluated at 1 week and after 3 years. There was a correlation between the pain duration before the surgery and pain relief after the surgery, with best correlation found between pain duration before surgery and pain relief 5 years after DREZ procedure (r = 0.623, P = 0.007).
The long-term follow up showed that the pain relief gradually decreased over 5 years after surgery. However, the pain relief still did not significantly decrease after 3 years.
分析臂丛神经撕脱所致去传入性疼痛患者的背根入髓区（DREZ）凝固性损伤的长期临床效果，并将DREZ凝固术后的疼痛缓解情况与DREZ凝固术前的疼痛持续时间相关联。
26例臂丛神经撕脱伤后顽固性去传入性疼痛患者在神经外科接受疼痛治疗。使用双极镊子沿DREZ进行交界性凝固损伤。患者在术后1周、1年、3年和5年使用视觉模拟量表评估术后镇痛效果。
DREZ手术后立即报告了最大程度的疼痛缓解。在5年的随访期内，疼痛缓解效果逐渐且显著降低。术后1周与1年后评估的疼痛缓解之间以及术后1周与3年后评估的疼痛缓解之间无显著差异。手术前的疼痛持续时间与手术后的疼痛缓解之间存在相关性，在DREZ手术后5年，手术前的疼痛持续时间与疼痛缓解之间的相关性最佳（r = 0.623，P = 0.007）。
长期随访表明，术后5年内疼痛缓解逐渐降低。然而，3年后疼痛缓解仍未显著降低。
