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计算机辅助立体定向三叉神经半月节射频热凝术+甘油注射治疗原发性三叉神经痛(附26例报道)

Semilunar ganglion radiofrequency thermorhizotomy and glycerol rhizotomy guided by Stereotactic Operation Planning System for idiopathic trigeminal neuralgia

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【作者】 金丹李云辉黄建龙林中平林泽森王雪涛敖文斌伍伟超雷金娣

【Author】 Jin Dan,Li Yunhui,Huang Jianlong,et al.Department of Neurosurgery,The Affiliated Zhongshan Hospital,Guangzhou University of Traditional Chinese Medicine,Zhongshan,528400

【机构】 广东省中山市中医院神经外科

【摘要】 目的探讨Brainlab立体定向手术计划系统及图像融合技术在三叉神经半月节射频热凝术+甘油注射治疗中的应用价值。方法对26例原发性三叉神经痛患者常规行MR扫描,头部安装Leksell立体定位头架后行CT扫描,将CT及MR图像输入Brainlab立体定向手术计划系统进行图像融合,直接定位半月神经节并确定穿刺路径。结果所有患者一次性穿刺成功率100%,无穿刺损伤所致并发症,术后疼痛立即消失,疗效优良率100%,术后面部感觉减退5例,均无特殊不适感。术后随访半年~1年,无继续服药患者及复发病例。结论立体定向图像融合技术能直接定位三叉神经半月节,并能对穿刺路径进行设定,结合术中电生理定位,确保能快速准确穿刺靶点,避免了穿刺的盲目性,显著提高了穿刺的准确性和治疗效果。

【Abstract】 Objective To discussion the value of Brainlab stereotactic operation planning system and image fusion technology in the trigeminal nerve radiofrequency thermocoagulation and glycerol rhizotomy.Methods 26 patients were scanned by MR,Their head were installed Leksell stereotactic instrument,and scanned by CT.CT and MR images were intered into Brainlab stereotactic operation planning system,and integration,location the semilunar ganglion and to determine the puncture path.Results The success rate of first puncture is 100% in All patients.No complications is caused by puncture injury.Pain disappeared immediately after operation.The good and excellent rate is 100%.5 cases of patients with facial sensory decline after operation.However,they all did not feel uncomfortable.All of the patients do not relapse After Follow-up of 6 months-12 months.And they do not have to take medication continuely.Conclusion Stereotactic image fusion technology can be directly targeted semilunar ganglion.Futhermore it can determine the Puncture path.Therefore it ensures puncture target rapidly and Accurately combined with intraoperative electrophySiological positioning.Opetation effect was significantly improved.

  • 【文献出处】 立体定向和功能性神经外科杂志 ,Chinese Journal of Stereotactic and Functional Neurosurgery , 编辑部邮箱 ,2010年02期
  • 【分类号】R745.11
  • 【被引频次】4
  • 【下载频次】112
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