[The histological changes in the spinal cord following percutaneous cervical cordotomy (PCC) and correlation of these changes with the efficacy of PCC].
We observed the histological changes in the spinal cord following percutaneous cervical cordotomy (PCC) and correlation of these changes with the efficacy of PCC in 7 cases. A fine monopolar electrode which we used, measured 0.25 mm or 0.27 mm in diameter with exposed length of 2 mm. An oval or elliptical-shaped lesion, 1 to 3 mm in width and 3 to 4 mm in length, was observed in 6 of these cases. The main lesion was found in the anterolateral column in 5 cases. In 3 of these 5 cases, the whole anterolateral column had been destroyed, and in the other 2 cases dorsal one half to two thirds of it had been destroyed. In these 5 cases, pain sensation on the opposite side of PCC was lost for a long time and pain was relieved until death (21-239 days after PCC). In the other 2 cases the lesion in the anterolateral column was tenuous or unrecognizable, and the loss of pain sensation was temporary with pain recurring by the next day. This study showed that an oval or elliptical-shaped lesion was made in PCC and that in cases in which main lesion was located in the anterolateral column, pain relief was long lasting.
Nagaro
T
T
Department of Anesthesiology & Resuscitology, University School of Medicine, Ehime.
Tabo
E
E
Kojo
H
H
Amakawa
K
K
Kimura
S
S
Arai
T
T
Sugita
A
A
D000328:Adult; D000368:Aged; D002818:Cordotomy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009333:Neck; D009369:Neoplasms / Q000503:physiopathology; D010148:Intractable Pain / Q000601:surgery*; D013116:Spinal Cord / Q000473:pathology*