[논문]Long Term Results of Microsurgical Dorsal Root Entry Zonotomy for Intractable Pain Associated with Brachial Plexus Injury

Park, Yeul-Bum; Kim, Seong-Ho; Kim, Sang-Woo; Chang, Chul-Hoon; Ahn, Sang-Ho; Jang, Sung-Ho

[국내논문] Long Term Results of Microsurgical Dorsal Root Entry Zonotomy for Intractable Pain Associated with Brachial Plexus Injury 원문보기

Journal of Korean Neurosurgical Society = 대한신경외과학회지, v.40 no.3, 2006년, pp.143 - 147

Park, Yeul-Bum (Departments of Neurosurgery, College of Medicine, Yeungnam University) , Kim, Seong-Ho (Departments of Neurosurgery, College of Medicine, Yeungnam University) , Kim, Sang-Woo (Departments of Neurosurgery, College of Medicine, Yeungnam University) , Chang, Chul-Hoon (Departments of Neurosurgery, College of Medicine, Yeungnam University) , Ahn, Sang-Ho (Departments of Rehabilitation Medicine, College of Medicine, Yeungnam University) , Jang, Sung-Ho (Departments of Rehabilitation Medicine, College of Medicine, Yeungnam University)

Abstract ▼ AI-Helper

Objective : Brachial plexus injury can produce a intractable chronic neuropathic pain. This study was undertaken to assess the long term outcome of microsurgical dorsal root entry zonotomy[MDT]. Methods : Between October 1997 and December 2002, 21 patients received MDT because of a intractable pain resulting from brachial plexus injury. Of these, 19 patients were followed for more than 2 years. Fourteen of 19 patients were male and patient ages ranged from 22 to 69 years. Mean pain duration was 36.8 months and all patients had severe pain of $9{\sim}10$ visual analogue scale. To achieve complete destruction of abnormal dorsal horns, thermocoagulation of the posterolateral sulcus were performed and careful gluing was done to prevent postoperative adhesion and pain recurrence. Results : Of the 19 patients, 15 patients had excellent [>75% reduction in pain] and good [$51{\sim}75%$ pain relief] results in a average postoperative period of 4.1 years. One patient had a poor [less than 25% pain relief] result. Three patients were considered to have a fair result [$26{\sim}50%$ pain relief]. Postoperative complications were 2 transient ipsilateral ataxia and 1 CSF fistula that resolved without surgical revision. Conclusion : These results indicate that MDT provides excellent long-term pain relief in medically intractable chronic neuropathic pain following brachial plexus injury without significant complications.

주제어

AI 본문요약
AI-Helper

* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.

제안 방법

8). Degree of pain relief was assessed immediately after surgery and at 3 months, 6 months, 1 year and last follow-up, and was compared with the level ofpain before surgery; Wlien necessary, for clarification purpose, patients were interviewed by telephone. Pain relief was rated as "excellent' ifpain relief was consistently >75%, “good” if 51~75%, afair，if 26 to 50%, or "poor" if <25% according to VAS scores.
After DREZ lesions performed to treat any kind of pain, patients have noted a slighdy "numb" sensation over a small number ofdermatomes caudal to the treatment area. In this study, postoperative complications were limited to two cases oftransient ipsilateral ataxia that recovered within 3 to 6 months, and a single CSF fistula that resolved without surgical revision. Those that developed postoperative ipsilateral ataxia with severely avulsed roots and cord deformation had unsatisfactory surgical outcomes.
DREZ is well known to have important role in the neurophysiologic balance between afferent and efferent pain impulses under the control ofexcitatory and inhibitory mechanisms2,5,19). The goal of the DREZ procedure is to destroy Rexed layers 1, 2, and 5, as well as the medial portion of the tract ofLissauer301. It is important to spare the lateral portion ofLissauers tract, which has been recognized to possess an inhibitory inter-segmental function that modulates dorsal horn pain22).
The purpose of the present study was to assess the long term outcome of microsurgical dorsal root entry zonotomy(MDT) for the treatment ofmedically intractable pain following brachial plexus injury.

데이터처리

Statistical analysis was performed using the repeated measure ofANOVA. Statistical significance was accepted when a probability was <5% (p<0.

이론/모형

Patient pain levels were recorded before and after operation using the 0 to 10 visual analogue scale(VAS). Preoperatively, according to this scale, all patients had severe pain (average VAS score 9.

참고문헌 (32)

Baranauskas G, Nistri A : Sensitization of pain pathways in the spinal cord : cellular mechanisms. Prog Neurobiol 54 : 349-365, 1998

상세보기
De La Motte C : Distribution of the tract of Lissauer and the dorsal root fibers in the primate spinal cord. J Comp Neurol 172 : 529-561, 1977

상세보기
Dreval ON : Ultrasonic DREZ-operations for treatment of pain due to brachial plexus avulsion. Acta Neurochir (Wien) 122 : 76-81, 1993

상세보기
Friedman AH, Nashold BS Jr : DREZ lesions for relief of pain related to spinal cord injury. J Neurosurg 65 : 465-469, 1986
Friedman AH, Nashold BS Jr, Bronec PR : Dorsal root entry zone lesions for the treatment of brachial plexus avulsion injuries : a follow-up study. Neurosurgery 22 : 369-373, 1988

상세보기
Kim DH, Murovic JA, Kline DG : Brachal plexus injury : mechanisms, surgical treatment and outcomes. J Korean Neurosurg Soc 36 : 177- 185, 2004

상세보기
Kim SR, Lee KJ, Cho JG, Rha HK, Park HK, Kang JK, et al : Microsurgical DREZotomy for deafferentation pain. J Korean Neurosurg Soc (Suppl I) 30 : S85-S90, 2001
Levy WJ, Nutkiewicz A, Ditmore QM, Watts C : Laser induced dorsal root entry zone lesions for pain control. Report of three cases. J Neurosurg 59 : 884-886, 1983

상세보기
Malcangio M, Ramer MS, Jones MG, McMahon SB : Abnormal substance P release from the spinal cord following injury to primary sensory neurons. Eur J Neurosci 12 : 397-399, 2000

상세보기
Narakas A : Surgical treatment of traction injuries of the brachial plexus. Clin Orthop Relat Res 133 : 71-90, 1978

상세보기
Nashold BS Jr : Current status of the DREZ operation : 1984. Neurosurgery 15 : 942-944, 1984

상세보기
Nashold BS Jr, Friedman A, Bullitt E : The status of dorsal root entry zone lesions in 1987. Clin Neurosurg 35 : 422-428, 1989
Nashold BS Jr, Ostdahl RH : Dorsal root entry zone lesions for pain relief. J Neurosurg 51 : 59-69, 1979

상세보기
Nashold BS Jr, Vieira J, el-Naggar AO : Pain and spinal cysts in paraplegia : treatment by drainage and DREZ operation. Br J Neurosurg 4 : 327- 335, 1990

상세보기
Nepomuceno C, Fine PR, Richard JS, Gowens H, Stover SL, Rantanuabol U, et al : Pain in patients with spinal cord injury. Arch Phys Med Rehabil 60 : 605-609, 1979
Nichols ML, Allen BJ, Rogers SD, Ghilardi JR, Honore P, Luger NM, et al : Transmission of chronic nociception by spinal neurons expressing the substance P receptor. Science 286 : 1558-1561, 1999

상세보기
Rath SA, Braun V, Soliman N, Antoniadis G, Richter HP : Results of DREZ coagulations for pain related to plexus lisions, spinal cord injuries and postherpetic neuralgia. Acta Neurochir (Wien) 138 : 364-369, 1996

상세보기
Richardson RR, Meyer PR, Cerullo LJ : Neurostimulation in the modulation of intractable paraplegic and traumatic neuroma pains. Pain 8 : 75-84, 1980

상세보기
Samii M, Bear-Henney S, Ludemann W, Tatagiba M, Blomer U : Treatment of refractory pain after brachial plexus avulsion with dorsal root entry zone lesions. Neurosurgery 48 : 1269-1277, 2001

상세보기
Sampson JH, Cashman RE, Nashold BS Jr, Friedman AH : Dorsal root entry zone lesions for intractable pain after trauma to the conus medullaris and cauda equina. J Neurosurg 82 : 28-34, 1995

상세보기
Saris SC, Iacono RP, Nashold BS Jr : Dorsal root entry zone lesions for post-amputation pain. J Neurosurg 62 : 72-76, 1985

상세보기
Sindou M : DREZ lesions for brachial plexus injury. Neurosurgery 23 : 528, 1988
Sindou M, Mertens P, Bendavid U, Garcia-Larrea L, Mauguiere F : Predictive value of somatosensory evoked potentials for long-lasting pain relief after spinal cord stimulation : practical use for patient selection. Neurosurgery 52 : 1374-1384, 2003

상세보기
Sindou M, Mertens P, Wael M : Microsurgical DREZotomy for pain due to spinal cord and/or cauda equina injuries : long-term results in a series of 44 patients. Pain 92 : 159-171, 2001

상세보기
Sindou M, Quoex C, Baleydier C : Fiber organization at the posterior spinal cord-rootlet junction in man. J Comp Neurol 153 : 15-26, 1974

상세보기
Spaic M, Markovic N, Tadic R : Microsurgical DREZotomy for pain of spinal cord and cauda equina injury origin : clinical characteristics of pain and implications for surgery in a series of 26 patients. Acta Neurochir (Wien) 144 : 453-462, 2002

상세보기
Terzis JK, Vekris MD, Soucacos PN : Outcomes of brachial plexus reconstruction in 204 patients with devastating paralysis. Plast Reconstr Surg 104 : 1221-1240, 1999

상세보기
Thomas DG, Jones SJ : Dorsal root entry zone lesions (Nashold's procedure) in brachial plexus avulsion. Neurosurgery 15 : 966-968, 1984

상세보기
Thomas DG, Kitchen ND : Long term follow up of dorsal root entry zone lesions in brachial plexus avulsion. J Neurol Neurosurg Psychiatry 57 : 737-738, 1994

상세보기
Whitworth LA, Feler CA : Application of spinal ablative techniques for the treatment of benign chronic painful conditions. Spine 27 : 2607- 2612, 2002

상세보기
Wynn Parry CB : Pain in avulsion lesions of the brachial plexus. Pain 9 : 41-53, 1980

상세보기
Wynn Parry CB : Pain in avulsion of the brachial plexus. Neurosurgery 15 : 960-965, 1984

상세보기

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증

[국내논문] Long Term Results of Microsurgical Dorsal Root Entry Zonotomy for Intractable Pain Associated with Brachial Plexus Injury 원문보기

Abstract ▼ AI-Helper

주제어

AI 본문요약
AI-Helper

제안 방법

데이터처리

이론/모형

성능/효과

참고문헌 (32)

이 논문을 인용한 문헌

저자의 다른 논문 :

관련 콘텐츠

원문 보기

원문 URL 링크

오픈액세스(OA) 유형

이 논문과 함께 이용한 콘텐츠

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

선택된 텍스트

연합인증

[국내논문] Long Term Results of Microsurgical Dorsal Root Entry Zonotomy for Intractable Pain Associated with Brachial Plexus Injury 원문보기

Abstract ▼ AI-Helper

주제어

AI 본문요약 엑셀 다운로드 AI-Helper

제안 방법

데이터처리

이론/모형

성능/효과

참고문헌 (32)

이 논문을 인용한 문헌

저자의 다른 논문 :

Park, Yeul-Bum (2) 김성호 (45) 김상우 (21) 장철훈 (21) 안상호 (19) 장성호 (22)

관련 콘텐츠

원문 보기

원문 URL 링크

오픈액세스(OA) 유형

이 논문과 함께 이용한 콘텐츠

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

선택된 텍스트

AI 본문요약
AI-Helper