Steel Dora, Kirkman Matthew A, Thompson Dominic N P, Aquilina Kristian
Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom.
J Neurosurg Pediatr. 2017 Sep;20(3):278-283. doi: 10.3171/2017.5.PEDS17119. Epub 2017 Jul 7.
Open anterolateral cordotomy is an effective treatment option for adults with intractable pain, but it has seldom been attempted in children. In the 2 previously reported cases in children, the procedure was used within 10 days of death from neoplastic disease. In this paper the authors describe 2 cases in which open cordotomy was used successfully in children outside the immediate terminal phase of disease. Both patients experienced effective analgesia with minimal adverse effects. The authors propose that consideration of cordotomy as an option for the management of intractable pain in children does not need to be delayed until death is imminent.
开放性前外侧脊髓切开术是治疗成人顽固性疼痛的一种有效方法,但很少应用于儿童。在之前报道的2例儿童病例中,该手术是在肿瘤性疾病导致死亡前10天内进行的。在本文中,作者描述了2例在疾病非终末期成功应用开放性脊髓切开术的儿童病例。两名患者均获得了有效的镇痛效果,且副作用极小。作者建议,对于儿童顽固性疼痛的治疗,无需等到临近死亡才考虑将脊髓切开术作为一种选择。