Sindou M, Mertens P, Keravel Y
Service de neurochirurgie A, hôpital neurologique Pierre-Wertheimer, université de Lyon.
Rev Prat. 1994 Sep 15;44(14):1911-7.
During these last years the methods and the indications of analgesic neurosurgery have respectively changed toward greater multiplicity and more selectivity. The conservative methods of neurostimulation have acquired a prominent place in some types of pain from neuropathic origin. Their aim is to reinforce inhibitory fibre function. Whatever the technique used, stimulation of peripheral nerves, of posterior funiculi of the spinal cord, of the thalamus or the cerebral cortex, it will be effective only if the target structures are not totally, anatomically and functionally, destroyed. Intrathecal morphine administration, has been shown to be useful to control some cancer-induced pain. Lastly, the techniques of interrupting the pathways of pain, achieving greater selectivity in their effects, remain the preferred treatment for some types of localised pain having precise mechanisms.
在过去几年中,镇痛神经外科的方法和适应症分别朝着更多样化和更具选择性的方向发展。神经刺激的保守方法在某些神经性疼痛类型中占据了显著地位。其目的是增强抑制性纤维功能。无论使用何种技术,刺激外周神经、脊髓后索、丘脑或大脑皮层,只有在目标结构在解剖学和功能上没有完全被破坏时才会有效。鞘内注射吗啡已被证明对控制某些癌症引起的疼痛有用。最后,阻断疼痛通路的技术,在其效果上具有更高的选择性,仍然是某些具有精确机制的局部疼痛类型的首选治疗方法。