Edgar R E, Best L G, Quail P A, Obert A D
Neuroscience Laboratory, Craig Hospital, Englewood, Colorado.
J Spinal Disord. 1993 Feb;6(1):48-56.
Our data demonstrate that approximately 23-29% of standard dorsal root entry zone (DREZ) microcoagulation procedures fail to relieve pain due to inadequate thermal lesions and that approximately 39% fail due to insufficient superior extent of lesions. The remaining failures are related to inadequate lesion placement, improper selection of patients, and, rarely, posttraumatic spinal deafferentation pain resulting from other non-DREZ mechanisms. Computer-assisted DREZ microcoagulation is a satisfactory procedure to treat intractable posttraumatic spinal deafferentation pain, brachial plexus avulsion pain, and lumbosacral nerve root avulsion pain. In all these conditions we have identified areas of abnormal focal hyperactivity in the DREZ area. Perhaps this procedure can be applied to other central pain conditions if, using this technique, abnormal focal hyperactivity is demonstrated to be present.
我们的数据表明，标准的背根入髓区（DREZ）微凝固手术中，约23% - 29%因热损伤不足而未能缓解疼痛，约39%因损伤范围不够上延而失败。其余的失败与损伤位置不当、患者选择不当有关，很少见的情况是由其他非DREZ机制导致的创伤后脊髓去传入性疼痛。计算机辅助DREZ微凝固是治疗难治性创伤后脊髓去传入性疼痛、臂丛神经撕脱伤疼痛和腰骶神经根撕脱伤疼痛的一种令人满意的手术方法。在所有这些情况下，我们在DREZ区域发现了异常的局灶性活动亢进区域。如果使用该技术证明存在异常的局灶性活动亢进，或许这种手术方法可应用于其他中枢性疼痛情况。
