D'Souza Ryan S., Hooten W M.
Mayo Clinic, Rochester, Minnesota
Mayo Clinic
A neurolytic block involves the targeted destruction of a nerve or nerve plexus. Neuroablation is frequently used to describe the physical interruption of pain through chemical, thermal, or surgical means. All neurolytic techniques cause Wallerian degeneration of the nerve axon distal to the lesion. In the early 20th century, chemicals were widely used for neurolysis. The first documented instance of chemical neurolysis was in 1863 by Luton, who administered irritant chemicals subcutaneously to patients with sciatic neuralgia, resulting in significant pain relief. Newer and safer modalities have since been introduced into pain practice, including radiofrequency ablation, cryoablation, and neurosurgical procedures. The advancements in imaging modalities such as fluoroscopy have improved the precision and efficiency of targeted neurolysis.
神经溶解阻滞涉及对神经或神经丛的靶向破坏。神经消融术常被用于描述通过化学、热或手术手段对疼痛进行的物理阻断。所有神经溶解技术都会导致病变远端神经轴突发生华勒氏变性。在20世纪初，化学物质被广泛用于神经溶解。化学神经溶解的首个有记录的案例是1863年由卢顿完成的，他给坐骨神经痛患者皮下注射刺激性化学物质，结果疼痛显著缓解。此后，更新、更安全的方法被引入疼痛治疗实践，包括射频消融、冷冻消融和神经外科手术。诸如荧光透视等成像方式的进步提高了靶向神经溶解的精确度和效率。
