【摘要】 采用脊髓背根神经入口处（ｄｏｒｓａｌ ｒｏｏｔ ｅｎｔｒｙ ｚｏｎｅ， ＤＲＥＺ）损毁术治疗臂丛神经根５５性撕脱伤后疼痛２例。手术先切除Ｃ４－７椎板，剪开硬膜暴露已撕脱Ｃ４－７节段后根神经及确定中间外侧沟后，将射频针与垂直方向呈２５°夹角插入该段脊髓左侧的中间外侧沟２ｍｍ深，损毁温度为７５℃，时间１５秒，每间隔１ｍｍ行一损毁灶，共计行１５个损毁灶。术后取得满意的止痛效果，但对侧肢体感觉轻度减退，２个月后恢复。ＤＲＥＺ损毁术的镇痛机制与破坏ＤＲＥＺ区过度活跃的神经元细胞，改变Ｌｉｓｓａｕｅｒ束在此区域的调节作用，破坏脊髓丘脑柬和脊髓网状束的细胞起源有关。ＤＲＥＺ的远期疗效及并发症的减少有待于进一步探索。更多还原

【Abstract】 Dorsal root entry zone ( DREZ ) destroy was used to treat 2 patients with pain due to dorsal roots. avulsion.. of the brachial l plexus. The laminectomy was. performed in the region of avulsion including C4. through C7. After the dura was exposed . an needle was introduced into the intermedia- lateral sulcus. at the site of rootlets. avulsion , at a depth of 2 mm , and angled 25 degrees in the laterome- dial direction. Lesions were made at 7 5℃ for 1 5 seconds at intervals of 1 mm. Both patients had good pain relief , but had mild sensory abnormality in ipsilateral lower limbs. The mechanisms of DREZ de- stroy in pain relief may include : 1 . destroy the hyper sensitive neurons. in this area : 2. destruction of cellular origins. of spinothalamus. and spinorecticular tracts. : ..3 modification of the influence of Lissauer’s. tract.更多还原