“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。

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY
Journal of neurosurgical sciences Pub Date : 2024-12-01 Epub Date: 2023-05-18 DOI:10.23736/S0390-5616.23.06018-6
Stefano Ferraresi, Lorenzo Maistrello, Elisabetta Basso, Piero DI Pasquale
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引用次数: 0

摘要

背景:臂丛撕脱伤引起的神经性神经传递障碍疼痛的治疗是神经外科实践中的一个主要问题,尽管罕见。本文的目的是一步一步地介绍众所周知的背根进入区病变的手术升级的主要原则,我们将其命名为香蕉分裂DREZotomy。方法:对三组患者进行比较,其中两组采用经典技术治疗,第三组术中不使用物理药物治疗脊髓。结果:根据正在进行的文献数据,患者按照既定的手术程序进行手术,短期成功率约为70%。相反,香蕉劈开技术的结果在缓解疼痛、没有真正的并发症和令人不快的副作用方面都令人惊讶。结论:一种称为DREZ病变的纯解剖技术手术方法克服了所有报道系列中30%的失败,显示出更好的结果。后角的深度和永久性分裂以及没有任何其他成分(热传播,射频或点状凝血)是可能解释这种突出结果的主要因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
Journal of neurosurgical sciences
Journal of neurosurgical sciences CLINICAL NEUROLOGY-SURGERY
CiteScore
3.00
自引率
5.30%
发文量
202
审稿时长
>12 weeks
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.
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