Ferraresi Stefano, Basso Elisabetta, Maistrello Lorenzo, Scerrati Alba, Di Pasquale Piero
Department of Neurosurgery, Ospedale Santa Maria della Misericordia, Rovigo, Italy.
Neurosurg Focus Video. 2020 Oct 1;3(2):V13. doi: 10.3171/2020.7.FOCVID2031. eCollection 2020 Oct.
The treatment of deafferentation pain is a primary goal of a referral center for peripheral nerve surgery. DREZ is an important asset in the neurosurgeon's armamentarium. The surgical technique and long-term results are analyzed in two series, with or without intraoperative monitoring (IOM). DREZotomy is highly effective in lumbar root avulsive injuries but is ineffective in resolving pain due to spinal cord injuries. Cervical DREZotomy for cancer pain is not superior to intrathecal morphine. In brachial plexus avulsive injuries, the largest series shows a 74% success rate, but the efficacy of the procedure is lost over time. No relevant difference has been observed since the introduction of IOM. The video can be found here: https://youtu.be/uG_kkQj5m1U.
去传入神经痛的治疗是周围神经外科转诊中心的主要目标。脊髓背根入髓区（DREZ）手术是神经外科医生的重要手段。本文分析了两个系列手术（有或没有术中监测（IOM））的手术技术和长期结果。DREZ切开术对腰神经根撕脱伤非常有效，但对脊髓损伤引起的疼痛无效。用于癌症疼痛的颈椎DREZ切开术并不优于鞘内注射吗啡。在臂丛神经撕脱伤中，最大的系列研究显示成功率为74%，但随着时间的推移该手术的疗效会丧失。自引入IOM以来，未观察到相关差异。视频可在此处找到：https://youtu.be/uG_kkQj5m1U 。
