Drezotomy and myelotomy for cancer pain.

IF 2.4 4区 医学 Q3 NEUROIMAGING
Patrick Mertens, Andréi Brinzeu
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引用次数: 0

Abstract

Background When conservative treatment, including intrathecal infusion of pharmacological agents, or even multimodal therapies are not sufficiently effective, if their respective benefits-risks balances are favorable, Drezotomy and myelotomy, ablative surgeries targeting sensory circuits in the spinal cord, may still have a place today for well selected patients. Summary In this review article, the rationale and technical principles and their current potential indications, based on their results published, are described. Drezotomy have been reported effective for topographically limited cancer pain caused by well-localized lesion, in particular if nociceptive and neuropathic components are combined. Currently, the open punctate midline myelotomy is used for patients with intractable visceral cancer pain, abdominal or pelvic, even bilateral. For patients with limited survival, percutaneous myelotomy is recommended, given the less invasive nature of the procedure. However, the technique chosen for myelotomy will ultimately depend on the surgeon's experience and expertise. Key messages In spite of data coming only from case series, DREZotomy and myelotomy, that are technically demanding procedures, can be still useful interventions and discussed for well selected patients suffering from intractable cancer pain.

癌性疼痛的Drezotomy和myeltomy。
背景:当保守治疗,包括鞘内药物输注,甚至多模式治疗都不够有效时,如果它们各自的收益-风险平衡是有利的,Drezotomy和myelelotomy,针对脊髓感觉回路的消融手术,今天仍然可以为精心挑选的患者提供一个位置。在这篇综述文章中,根据已发表的结果,描述了其基本原理和技术原理及其当前潜在适应症。据报道,对于由定位良好的病变引起的地形性有限的癌性疼痛,特别是如果伤害性和神经性成分结合在一起,Drezotomy是有效的。目前,开放式点状中线髓切开术用于顽固性内脏癌性疼痛,腹部或骨盆,甚至双侧。对于生存期有限的患者,建议采用经皮髓切开术,因为该手术的侵入性较小。然而,脊髓切开术的技术选择最终取决于外科医生的经验和专业知识。尽管数据仅来自病例系列,但DREZotomy和骨髓切开术,这是技术上要求很高的手术,仍然可以作为有效的干预措施,并被讨论为精心挑选的患有难治性癌症疼痛的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.80
自引率
0.00%
发文量
33
审稿时长
3 months
期刊介绍: ''Stereotactic and Functional Neurosurgery'' provides a single source for the reader to keep abreast of developments in the most rapidly advancing subspecialty within neurosurgery. Technological advances in computer-assisted surgery, robotics, imaging and neurophysiology are being applied to clinical problems with ever-increasing rapidity in stereotaxis more than any other field, providing opportunities for new approaches to surgical and radiotherapeutic management of diseases of the brain, spinal cord, and spine. Issues feature advances in the use of deep-brain stimulation, imaging-guided techniques in stereotactic biopsy and craniotomy, stereotactic radiosurgery, and stereotactically implanted and guided radiotherapeutics and biologicals in the treatment of functional and movement disorders, brain tumors, and other diseases of the brain. Background information from basic science laboratories related to such clinical advances provides the reader with an overall perspective of this field. Proceedings and abstracts from many of the key international meetings furnish an overview of this specialty available nowhere else. ''Stereotactic and Functional Neurosurgery'' meets the information needs of both investigators and clinicians in this rapidly advancing field.
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