Singh J P, Chandy M J, Joseph T, Chandi S M
Department of Neurological Sciences, Christian Medical College Hospital Vellore, India.
Br J Neurosurg. 1989;3(3):373-9. doi: 10.3109/02688698909002818.
Dorsal Root Entry Zone (DREZ) thermocoagulation using radiofrequency has successfully been employed in the treatment of various deafferentation pain syndromes. The ability of surgical lasers to produce discrete lesions with precision has prompted their use in DREZ lesioning. The effects of carbon-dioxide laser induced DREZ lesions in the primate spinal cord were studied in the Bonnet monkey and the parameters necessary to produce a histologically ideal DREZ lesion were evaluated. Lesions were made with 10, 15 and 20 Watts power for pulse durations of 100 to 400 milliseconds at a constant beam spot size of 0.4 mm. It was found that histologically ideal lesions were produced with 20 Watts of power and a pulse duration of 300 milliseconds and with 15 Watts power and 400 millisecond pulse duration. The lesion lengths and widths at different parameters were also comparatively evaluated. The postulated mechanisms of deafferentation pain and the possible mode of action of DREZ lesions in management of pain are also reviewed.
使用射频的背根入髓区（DREZ）热凝术已成功应用于各种传入神经阻滞性疼痛综合征的治疗。外科激光精确产生离散性损伤的能力促使其被用于DREZ毁损术。在帽猴身上研究了二氧化碳激光诱导的灵长类脊髓DREZ损伤的效果，并评估了产生组织学理想的DREZ损伤所需的参数。在恒定光斑尺寸为0.4毫米的情况下，以10、15和20瓦的功率进行损伤，脉冲持续时间为100至400毫秒。结果发现，使用20瓦功率和300毫秒的脉冲持续时间以及15瓦功率和400毫秒的脉冲持续时间可产生组织学理想的损伤。还对不同参数下损伤的长度和宽度进行了比较评估。文中还回顾了传入神经阻滞性疼痛的假定机制以及DREZ损伤在疼痛管理中的可能作用方式。
