Stefano Ferraresi, Lorenzo Maistrello, Elisabetta Basso, Piero DI Pasquale
{"title":"“香蕉劈开式DREZotomy”:一种改善臂丛神经损伤后背根进入区损伤后疼痛缓解的无创性方法。病例系列和治疗原则。","authors":"Stefano Ferraresi, Lorenzo Maistrello, Elisabetta Basso, Piero DI Pasquale","doi":"10.23736/S0390-5616.23.06018-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The treatment of neuropathic deafferentation pain due to avulsion injuries of the brachial plexus is a major problem, albeit rare, in the neurosurgical practice. The aim of the paper is to present step-by-step the main principles of a surgical upgrade of the well-known Dorsal Root Entry Zone lesioning, that we named banana splitting DREZotomy.</p><p><strong>Methods: </strong>A comparison is made among three groups of patients, two of which were treated following the classic techniques, while in the third no physical agent is applied to the spinal cord during surgery.</p><p><strong>Results: </strong>The patients operated on following the well-established surgical procedures showed a short-term success rate around 70%, online with the data of the ongoing literature. The results with the banana-splitting technique, instead, have been astonishing both in terms of resolution of pain, absence of true complications and of unpleasant side effects.</p><p><strong>Conclusions: </strong>A purely dissective technical variant of the surgical procedure called DREZ lesioning has shown better results overcoming the 30% failures of all the reported series. The profound and permanent splitting of the posterior horn and the absence of any other component (heat propagation, radiofrequency, or dotted coagulation) are the major factors which may explain such outstanding results.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"704-713"},"PeriodicalIF":1.3000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The \\\"banana splitting DREZotomy\\\": an atraumatic method to improve pain relief after dorsal root entry zone lesioning in brachial plexus injuries. Case series and tenets for the treatment.\",\"authors\":\"Stefano Ferraresi, Lorenzo Maistrello, Elisabetta Basso, Piero DI Pasquale\",\"doi\":\"10.23736/S0390-5616.23.06018-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The treatment of neuropathic deafferentation pain due to avulsion injuries of the brachial plexus is a major problem, albeit rare, in the neurosurgical practice. The aim of the paper is to present step-by-step the main principles of a surgical upgrade of the well-known Dorsal Root Entry Zone lesioning, that we named banana splitting DREZotomy.</p><p><strong>Methods: </strong>A comparison is made among three groups of patients, two of which were treated following the classic techniques, while in the third no physical agent is applied to the spinal cord during surgery.</p><p><strong>Results: </strong>The patients operated on following the well-established surgical procedures showed a short-term success rate around 70%, online with the data of the ongoing literature. The results with the banana-splitting technique, instead, have been astonishing both in terms of resolution of pain, absence of true complications and of unpleasant side effects.</p><p><strong>Conclusions: </strong>A purely dissective technical variant of the surgical procedure called DREZ lesioning has shown better results overcoming the 30% failures of all the reported series. The profound and permanent splitting of the posterior horn and the absence of any other component (heat propagation, radiofrequency, or dotted coagulation) are the major factors which may explain such outstanding results.</p>\",\"PeriodicalId\":16504,\"journal\":{\"name\":\"Journal of neurosurgical sciences\",\"volume\":\" \",\"pages\":\"704-713\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of neurosurgical sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.23736/S0390-5616.23.06018-6\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/5/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of neurosurgical sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23736/S0390-5616.23.06018-6","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/5/18 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
The "banana splitting DREZotomy": an atraumatic method to improve pain relief after dorsal root entry zone lesioning in brachial plexus injuries. Case series and tenets for the treatment.
Background: The treatment of neuropathic deafferentation pain due to avulsion injuries of the brachial plexus is a major problem, albeit rare, in the neurosurgical practice. The aim of the paper is to present step-by-step the main principles of a surgical upgrade of the well-known Dorsal Root Entry Zone lesioning, that we named banana splitting DREZotomy.
Methods: A comparison is made among three groups of patients, two of which were treated following the classic techniques, while in the third no physical agent is applied to the spinal cord during surgery.
Results: The patients operated on following the well-established surgical procedures showed a short-term success rate around 70%, online with the data of the ongoing literature. The results with the banana-splitting technique, instead, have been astonishing both in terms of resolution of pain, absence of true complications and of unpleasant side effects.
Conclusions: A purely dissective technical variant of the surgical procedure called DREZ lesioning has shown better results overcoming the 30% failures of all the reported series. The profound and permanent splitting of the posterior horn and the absence of any other component (heat propagation, radiofrequency, or dotted coagulation) are the major factors which may explain such outstanding results.
期刊介绍:
The Journal of Neurosurgical Sciences publishes scientific papers on neurosurgery and related subjects (electroencephalography, neurophysiology, neurochemistry, neuropathology, stereotaxy, neuroanatomy, neuroradiology, etc.). Manuscripts may be submitted in the form of ditorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.