[Surgery of the radiculo-spinal cord junction in the treatment of chronic pain and incapacitating spasticity. Report of a series of 29 patients].
This series involves 29 patients treated for chronic pain (9 patients) or severe spasticity (20 patients). The surgical technique used was the microsurgical D.R.E.Z.-tomy technique as described by Sindou. In the first group, three patients had malignant pain, while the six others had deafferation pain. In the second group, spasticity involved the upper limb in 13 patients and the lower limbs in 7 patients. Out of 20 patients, one-third suffered from cerebral palsy. In the first group, results one year after surgery were excellent or good in 7 out of the 9 patients. In the group treated for spasticity, a significant decrease in spastic disorders was observed in 16 of the 20 patients over a 1 to 4 year follow-up period. There was also an improvement of voluntary movements in 11 patients and a decrease in pain in 15 patients belonging to this group. A number of complications were noted: cerebrospinal fluid leakage in two cases, painful anesthesia in the C5 to T1 territory in one case, transient paresis of the upper limb in six cases. One patient died as a result of an expansive pneumatocele (3.4% of cases).
Abdennebi
B
B
Service de Neurochirurgie, Hôpital Salim Zmirli, El-Harrach, Alger, Algérie.
Furaha
K
K
Chitti
M
M
D000293:Adolescent; D000328:Adult; D002648:Child; D002908:Chronic Disease; D005121:Extremities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009128:Muscle Spasticity / Q000601:surgery*; D010146:Pain / Q000601:surgery*; D011184:Postoperative Period; D013116:Spinal Cord / Q000601:surgery*; D013126:Spinal Nerve Roots / Q000601:surgery*
Chirurgie à la jonction radiculo-médullaire dans le traitement des douleurs chroniques et de la spasticité handicapante. A propos d'une série de 29 patients.