带:与慢性难治疼痛作斗争的中心热点?
Linda Kollenburg1, Hisse Arnts1, Alexander Green2
1Radboud University Medical Center, Department of Neurosurgery, Functional Neurosurgery Unit, Nijmegen, 6525 GA, Netherlands.
Brain communications
|October 31, 2024
概括
神经外科干预,如带膜切除和前带膜皮层的深度大脑刺激,为慢性难治疼痛提供了有效的最后手段,特别是当有情感成分时. 这些先进的治疗方法需要重新考虑耐火性疼痛管理.
科学领域:
- 神经外科 神经外科
- 疼痛管理 疼痛管理
- 神经学 神经学
背景情况:
- 慢性疼痛带来了重大的社会经济负担.
- 药理和轻微侵入性治疗对一些患者来说是不够的.
- 耐火性慢性疼痛需要探索先进的神经外科干预措施.
研究的目的:
- 评估线圈切除术和前带带皮层深度大脑刺激在慢性难治疼痛方面的疗效.
- 提供现有数据的概述,以告知临床实施.
- 评估带状作为神经外科目标的潜力.
主要方法:
- 在PubMed数据库中进行文献搜索.
- 手动搜索引用的文章和评论.
- 包括24篇关于环膜切割的文章和5篇关于深度大脑刺激分析的文章.
主要成果:
- 在≤6个月的患者中,Cingulotomy在51-64%的患者 (新发性和非新发性疼痛) 显示出有效性,并在≥12个月的患者中显示出76-82%的有效性.
- 前带带皮层的深度大脑刺激表明,在≤6个月和≥12个月的非新生病性疼痛中,响应率为57-59%.
- 包括的不良事件包括影响变化/混对线圈切割术和感染/发作/语义流性下降对深度大脑刺激.
结论:
- 带膜切割和前带膜皮层的深度大脑刺激是对耐火性疼痛的有效的最后手段治疗,特别是有情感成分的治疗.
- 这些神经外科的方法应该重新考虑在慢性难治性疼痛的管理.
- 建议进一步研究带状作为神经外科的目标.
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