Nagaro T, Tabo E, Kojo H, Amakawa K, Kimura S, Arai T, Sugita A
Department of Anesthesiology & Resuscitology, University School of Medicine, Ehime.
Masui. 1995 Mar 3;44(3):325-30.
We observed the histological changes in the spinal cord following percutaneous cervical cordotomy (PCC) and correlation of these changes with the efficacy of PCC in 7 cases. A fine monopolar electrode which we used, measured 0.25 mm or 0.27 mm in diameter with exposed length of 2 mm. An oval or elliptical-shaped lesion, 1 to 3 mm in width and 3 to 4 mm in length, was observed in 6 of these cases. The main lesion was found in the anterolateral column in 5 cases. In 3 of these 5 cases, the whole anterolateral column had been destroyed, and in the other 2 cases dorsal one half to two thirds of it had been destroyed. In these 5 cases, pain sensation on the opposite side of PCC was lost for a long time and pain was relieved until death (21-239 days after PCC). In the other 2 cases the lesion in the anterolateral column was tenuous or unrecognizable, and the loss of pain sensation was temporary with pain recurring by the next day. This study showed that an oval or elliptical-shaped lesion was made in PCC and that in cases in which main lesion was located in the anterolateral column, pain relief was long lasting.
我们观察了7例经皮颈髓切断术（PCC）后脊髓的组织学变化，以及这些变化与PCC疗效的相关性。我们使用的细单极电极直径为0.25毫米或0.27毫米，暴露长度为2毫米。在其中6例中观察到宽度为1至3毫米、长度为3至4毫米的椭圆形或椭圆状病变。5例主要病变位于脊髓前外侧柱。在这5例中的3例中，整个脊髓前外侧柱被破坏，另外2例中其背侧二分之一至三分之二被破坏。在这5例中，PCC对侧的痛觉长期丧失，疼痛缓解直至死亡（PCC后21至239天）。另外2例中，脊髓前外侧柱的病变轻微或无法辨认，痛觉丧失是暂时的，第二天疼痛复发。本研究表明，PCC会造成椭圆形或椭圆状病变，且主要病变位于脊髓前外侧柱的病例中，疼痛缓解是持久的。
