Levy W J, Gallo C, Watts C
Neurosurgery. 1985 Mar;16(3):327-30. doi: 10.1227/00006123-198503000-00008.
Dorsal root entry zone lesions are effective in the control of intractable pain in several types of spinal cord injuries. Traditionally, these lesions have been made with the radiofrequency technique. This is effective, but has the drawback of being laborious, and there is a significant incidence of permanent weakness. We have evaluated the carbon dioxide laser, hoping that it would be both faster and more controlled, thereby offering the chance to lower the complication rate. In comparing a parallel series of radiofrequency and laser dorsal root entry zone lesions along the cat's spinal cord, we observed that the radiofrequency lesion was larger. In addition, it had 3 times more variability in its size than the laser lesion. We attribute this in part to the nature of the laser in making a very precise and reproducible lesion. Second, the extremely brief pulse of the laser, a fraction of a second, means that movement of the spinal cord from respiration and heartbeat and movement of the surgical instrument from the surgeon's hand become far less important in inducing lesion variability. We also studied for 2 months a series of chronic cats; there were no complications due to the laser. This work suggests that the laser is a useful instrument for dorsal root entry zone lesions, but requires more precise aiming and focusing.
背根入髓区损伤对控制几种类型脊髓损伤中的顽固性疼痛有效。传统上，这些损伤是通过射频技术造成的。这是有效的，但有费力的缺点，并且存在显著的永久性无力发生率。我们评估了二氧化碳激光，希望它既更快又更可控，从而有机会降低并发症发生率。在比较沿猫脊髓的一系列平行的射频和激光背根入髓区损伤时，我们观察到射频损伤更大。此外，其大小的变异性比激光损伤大3倍。我们部分将此归因于激光形成非常精确且可重复损伤的性质。其次，激光极其短暂的脉冲，仅几分之一秒，意味着呼吸和心跳引起的脊髓运动以及外科器械因外科医生手部动作引起的运动在导致损伤变异性方面变得远不那么重要。我们还对一系列慢性猫进行了为期2个月的研究；未出现因激光导致的并发症。这项工作表明激光是用于背根入髓区损伤的有用器械，但需要更精确的瞄准和聚焦。
