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KMID : 0359819950240020143
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Journal of Korean Neurosurgical Society
1995 Volume.24 No. 2 p.143 ~ p.150
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The Efficacy of Dorsal Root Entry Zone(DREZ) Lesions Making for Intractable Pain and DREZ-otomy for Intractable Spasticity.
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김영석
김범태/신원한/최순관/변박장
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Abstract
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The dorsal root entry zone (DREZ) lesions making by focal destruction of the substantia gelatinosa controls intractable pain. and the DREZ-otomy by the selective destroying mainly the laterally located nociceptive and centrally located myotactic
fibers
within the posterior root relieves the spasticity of the limbs.
The authors analysed the results of 12 patients. treated by the DREZ lesions making for intractable pain. and 6 patients. treated by the DREZ-otomy for intractable spasticity of lower extremities. who were admitted to department of neurosurgery
of
Soonchunhyang University from 1983 to 1993.
@ES The obtained results were as follows.
@EN 1) Among the 12 patients sufferred from intractable pain. three brachial plexus avulsion. three were spinal cord injury. two were causalgia. and the others were paraneoplastic syndrome. metastatic carcinoma. postoperative spinal cord tumor.
and
atypical facial pain respectively.
There were six patients intractable spasticity of that major cause was diffuse axonal injury (67%). and of that major posture was decorticate rigidity (8.3%).
2) The rate of immediate relief of intractable pain and spasticity was 82% in each after DREZ lesions making or DREZ-otomy.
3) The result of pain relief by the DREZ lesions making was excellent (100%) in brachial plexus avulsion. and poor (almost no relief) in paraplegic pain of spinal cord injury.
4) After DREZ-otomy on bilateral conus medullaris sparing S2-4 segment. the degree of spasticity of lower extremitries reduced gradually to mean Ashworth scale 2.1 from mean 5.
5) Five of six patients of the bedridden state due to harmful spasticity was able to do comfortably wheel chair ambulation immediately after operation.
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KEYWORD
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