Kiriakopoulos E T, Tasker R R, Nicosia S, Wood M L, Mikulis D J
Division of Neurosurgery, Toronto Hospital, Ontario, Canada.
Neurosurgery. 1997 Aug;41(2):501-4. doi: 10.1097/00006123-199708000-00042.
The management of chronic pain of spinal origin continues to represent a challenge for neurosurgeons. Spinal cord stimulation for chronic intractable pain is an effective therapy in approximately 50% of patients. The present study uses a novel imaging approach, functional magnetic resonance imaging (fMRI), to examine the central effects of spinal cord stimulation.
Three patients, each with a chronic history of intractable pain, were treated at the Toronto Hospital with a trial of dorsal column stimulation (DCS). For all patients, significant improvement in pain symptoms was achieved with DCS.
fMRI on a 1.5-T conventional magnetic resonance system was used to study the effects of DCS in these patients. Images were collected while the stimulator was activated and deactivated.
This report is the first to describe the cerebral effects of exogenous spinal cord stimulation with fMRI. fMRI allows for the objective examination of the effects of DCS and may provide an objective means of evaluating the efficacy of DCS as a therapy for intractable pain of spinal origin.
脊髓源性慢性疼痛的管理对神经外科医生来说仍然是一项挑战。脊髓刺激治疗慢性顽固性疼痛在大约50%的患者中是一种有效的疗法。本研究采用一种新颖的成像方法，即功能磁共振成像（fMRI），来研究脊髓刺激的中枢效应。
三名患有慢性顽固性疼痛病史的患者在多伦多医院接受了背柱刺激（DCS）试验治疗。对所有患者而言，DCS使疼痛症状得到了显著改善。
使用1.5-T传统磁共振系统上的fMRI来研究DCS对这些患者的影响。在刺激器开启和关闭时收集图像。
本报告首次描述了利用fMRI对外源性脊髓刺激的脑效应。fMRI能够客观地检查DCS的效果，并可能提供一种客观手段来评估DCS作为脊髓源性顽固性疼痛治疗方法的疗效。
