Young R F, Vermeulen S S, Grimm P, Posewitz A E, Jacques D B, Rand R W, Copcutt B G
Northwest Hospital Gamma Knife Center, Seattle, Wash., USA.
Stereotact Funct Neurosurg. 1995;64 Suppl 1:172-81. doi: 10.1159/000098777.
Twenty patients who suffered persistent intractable pain from a variety of disorders underwent medial thalamotomy with the Leksell Gamma Knife. The lesions were directed at the intralaminar nuclei, the lateral portion of the medial dorsal nucleus, the centromedian and the parafascicular nuclei. Lesions were made with radiation doses from 140 to 180 Gy using a 4-mm beam collimator helmet and either a single isocenter (1 patient), two isocenters (17 patients) or three isocenters (2 patients). Two thirds of the patients experienced either excellent or good pain relief in a follow-up period between 1 and 22 months. One patient showed temporary complications which resolved, and 2 other patients also suffered complications which currently are improving. One patient died due to radiation necrosis following a bilateral thalamotomy. Gamma Knife thalamotomy may offer a potentially safe and effective alternative for the treatment of certain difficult persistent pain problems.
20例因各种疾病遭受持续性顽固性疼痛的患者接受了Leksell伽玛刀内侧丘脑切开术。毁损靶点为板内核、背内侧核外侧部、中央中核和束旁核。使用4毫米准直器头盔，以140至180 Gy的辐射剂量进行毁损，采用单等中心（1例患者）、两个等中心（17例患者）或三个等中心（2例患者）。三分之二的患者在1至22个月的随访期内疼痛缓解良好或极佳。1例患者出现了可缓解的暂时性并发症，另外2例患者也出现了并发症，目前正在改善。1例患者在双侧丘脑切开术后因放射性坏死死亡。伽玛刀丘脑切开术可能为某些难治性持续性疼痛问题提供一种潜在安全有效的治疗选择。
