Saris S C, Iacono R P, Nashold B S
J Neurosurg. 1985 Jan;62(1):72-6. doi: 10.3171/jns.1985.62.1.0072.
Chronic pain following an amputation may involve the stump, the phantom limb, or both. Operations such as rhizotomy, cordotomy, stump revision, and dorsal column stimulation have been unsuccessful in treating this condition. This study evaluates the effectiveness of dorsal root entry zone (DREZ) coagulation for this pain problem. The authors studied 22 patients with amputations due to trauma, gangrene, or cancer. All developed post-amputation pain, underwent a DREZ procedure, and were followed from 6 months to 4 years after surgery. Overall, only eight (36%) of these 22 patients had pain relief. However, good results were obtained in six (67%) of nine patients with phantom pain alone, and in five (83%) of six patients with traumatic amputations associated with root avulsion. Poor results were obtained in patients with both phantom and stump pain, or stump pain alone. The DREZ procedure has a limited, but definite, place in the treatment of post-amputation pain.
截肢后的慢性疼痛可能涉及残端、幻肢或两者皆有。诸如神经根切断术、脊髓前侧柱切断术、残端修复术和背柱刺激术等手术在治疗这种病症方面均未成功。本研究评估了背根入髓区（DREZ）凝固术对这种疼痛问题的疗效。作者研究了22例因创伤、坏疽或癌症而截肢的患者。所有患者均出现了截肢后疼痛，接受了DREZ手术，并在术后6个月至4年进行了随访。总体而言，这22例患者中只有8例（36%）疼痛得到缓解。然而，仅患有幻肢痛的9例患者中有6例（67%）取得了良好效果，伴有神经根撕脱的6例创伤性截肢患者中有5例（83%）取得了良好效果。同时患有幻肢痛和残端痛或仅患有残端痛的患者效果较差。DREZ手术在截肢后疼痛的治疗中具有有限但明确的地位。
