Sindou M, Keravel Y
Neurochirurgie. 1979;25(3):166-72.
200 cases of percutaneous thermocoagulation of the trigeminal nerve were studied in order to determine if the position of the thermolesion in the various parts of the trigeminal system modified the quality of the results and the frequency of post-operative complications. An anatomo-radiological study allowed the precise localisation in the sagittal plane of the position of the different parts of the trigeminal ganglion with respect to the neighbouring bony features. The quality of the results and the frequency of complications were studied according to the level of the thermolesion (ganglion, triangular plexus, posterior sensory root). This study permitted the observation that the more posterior the thermolesion, the less frequent the complication, and this confirmed results obtained in earlier procedures, c.g. gasserian or retro-gasserian neurotomy. Post-operative hypoaesthesia extending beyond the painful area, was the major side-effect of the radicular position of the thermolesion. There follows a discussion of the criteria, which permit the recognition of the point of the electrode at the level of the posterior root: the flow of CSF, vasodilatation, and radiological localisations. Of these three criteria, only radiological demonstration (point of the needle posterior to the clivus and above the petrous temporal bone) seemed reliable.
为了确定三叉神经系统不同部位热凝损伤的位置是否会改变治疗效果及术后并发症的发生率，对200例三叉神经经皮热凝术进行了研究。一项解剖放射学研究实现了在矢状面内精确确定三叉神经节不同部位相对于相邻骨质结构的位置。根据热凝损伤的水平（神经节、三角神经丛、后感觉根）对治疗效果和并发症发生率进行了研究。该研究观察到热凝损伤越靠后，并发症发生频率越低，这证实了早期手术（如半月神经节或半月神经节后神经切断术）所获得的结果。热凝损伤位于神经根水平时，术后感觉减退超出疼痛区域是主要的副作用。接下来讨论了用于识别后根水平电极位置的标准：脑脊液流动、血管扩张和放射学定位。在这三个标准中，只有放射学显示（针的位置在斜坡后方和颞骨岩部上方）似乎可靠。
