脊髓刺激疼痛神经病 Cauda Equina 综合征后弹道穿透的腰椎损伤:概念验证案例
Nathan Beucler1, Hubert Tournebise2, Rayan Fawaz3,4
1Neurosurgery Department, Sainte-Anne Military Teaching Hospital, Toulon, 83800, France.
Military medicine
|October 15, 2025
概括
脊髓刺激可以缓解经过透性脊髓损伤后的慢性神经病痛. 这个案例表明,在以前对医疗治疗没有反应的平民患者身上,疼痛显著减少,功能改善.
科学领域:
- 神经外科 神经外科
- 疼痛管理 疼痛管理
- 创伤外科 手术 创伤外科
背景情况:
- 透性脊柱损伤影响军人和平民,可能导致慢性神经病痛.
- 下肢神经病痛可能对传统的医学治疗不耐药.
研究的目的:
- 在透脊髓损伤后,通过胸脊髓刺激成功治疗下肢神经病痛的病例.
- 为了评估脊髓刺激的长期疗效,在一个具有耐火性神经病态尾部马尾综合征的平民患者.
主要方法:
- 一名58岁的平民有穿透性脊柱损伤L2和随后的神经病态尾部马尾综合征的病史被治疗.
- 下胸脊髓刺激是在经历了12年的耐火性疼痛后手术实施的.
- 在18个月的时间里,使用奥斯韦斯特里残疾指数 (ODI) 和视觉模拟量表 (VAS) 评估了疼痛和功能结果.
主要成果:
- 患者经历了显著的疼痛缓解,VAS疼痛得分从8/10降低到5/10.
- 在18个月的随访后,ODI得分从56%降至28%的功能性改善.
- 脊髓刺激为透后脊髓损伤的难治性神经病痛提供了可行的治疗选择.
结论:
- 胸脊髓刺激可以作为一种有效的手术选择,用于治疗经过透性脊髓损伤后的慢性,难治的神经病性下肢疼痛.
- 这一案例凸显了脊髓刺激对遭受脊髓创伤后衰弱性疼痛的军事和平民人口的潜力.
- 需要进一步的研究来确定脊髓刺激作为这个患者群体的标准治疗.
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