Kanpolat Y, Deda H, Akyar S, Bilgiç S
University of Ankara, Ibni Sina Medical Center, Department of Neurosurgery and Radiology, Turkey.
Acta Neurochir Suppl (Wien). 1989;46:67-8. doi: 10.1007/978-3-7091-9029-6_16.
Percutaneous cordotomy is a commonly applied and effective procedure among the ablative pain surgeries. As plain X-ray does not permit visualization of the target relative to the electrode the chances of obtaining good results are decreased and the risk of complications are increased. The use of CT has been found to be useful in cordotomy. The procedure is performed under CT control on the patients who have previously been given 5 ml iohexol into the subarachnoid space. The needle electrode is manipulated by free hand technique. It is possible to measure the diameter of the spinal cord and to detect cord dislocation in the spinal canal. When the electrode system is introduced it is possible to visualize the tip of the electrode which is pushing or puncturing the spinal cord. As the procedure directly visualizes the relation of the electrode to the target it is possible to place the electrode in the lateral spinothalamic tract. Another advantage of the procedure is to enable us to visualize haematomas or other changes that may result from the cordotomy. The application of the technique and clinical results will be presented.
经皮脊髓切断术是一种在消融性疼痛手术中常用且有效的手术方法。由于普通X射线无法显示靶点相对于电极的位置，获得良好效果的几率降低，并发症风险增加。已发现CT在脊髓切断术中很有用。该手术在CT引导下对先前已向蛛网膜下腔注入5毫升碘海醇的患者进行。针电极采用徒手技术操作。可以测量脊髓直径并检测脊髓在椎管内的移位情况。当引入电极系统时，可以看到电极尖端正在推压或穿刺脊髓。由于该手术能直接观察电极与靶点的关系，所以可以将电极置于脊髓丘脑侧束。该手术的另一个优点是使我们能够观察到脊髓切断术可能导致的血肿或其他变化。将介绍该技术的应用及临床结果。
