全脊髓毁损术治疗截瘫后神经痛的临床研究  

CT guided continuous radiofrequency thermocoagulation of spinal cord for treatment of refractory neuralgia after paraplegia caused by spinal cord injury

作　　者：赖光辉[1] 李玄英[1] 倪家骧[1] 

机构地区：[1]首都医科大学宣武医院疼痛科,北京100053

出　　处：《首都医科大学学报》2014年第1期10-12,共3页Journal of Capital Medical University

基　　金：北京市科委成果推广项目(Z111107066411010)~~

摘　　要：目的 探讨全脊髓毁损术对治疗脊髓损伤截瘫后顽固性神经痛方法的可行性、安全性和有效性.方法 14例脊髓损伤后神经痛患者经过磁共振检查和体格检查确定损伤平面,在其上1~2个节段,应用CT引导定位经椎板穿刺至脊髓进行持续射频热凝治疗.结果 所有患者均毁损成功,除1例在治疗后3年疼痛复发进行二次脊髓毁损治疗后疼痛消失外,其余患者均无疼痛发生,其有效率为92.9%.结论 全脊髓毁损对于治疗脊髓损伤截瘫后神经痛可做到安全,有效和准确具有临床实用价值.Objective To investigate the feasibility, safety, and efficacy of spinal cord cross-sectional CT guided continuous radiofrequency thermocoagulation in treatment of refractory neuralgia after paraplegia caused by spinal cord injury. Methods Fourteen cases with refractory neuralgia caused by spinal cord injury were included in this study. The damage level of spinal cord injury was verified by magnetic resonance imaging （MRI） and physical examination. At 1-2 segments above the damage level, a puncture was performed trans-lamina to the spinal cord with CT guide and followed by continuous radiofrequency thermocoagulation therapy to the target. Results All treatments were successful. One patient＇s pain recurred 3 years after the treatment, and disappeared after another spinal cord radiofrequency thermocoagulation therapy. The remaining patients had no pain, the efficacy was 92.9%. Conclusion Spinal cord CT-guided continuous radiofrequency thermocoagulation therapy for refractory neuralgia after spinal cord injury is a Safe, effective and accurate method and has clinical practical value.

关 键 词：全脊髓毁损 脊髓损伤 神经病理性疼痛 

分 类 号：R441.1[医药卫生—诊断学]