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불인통에 대한 외과적 치료의 임상적 고찰 Clinical observation on the surgical treatment of the intractable pain

대한신경외과학회지 1973년 2권 1호 p.50 ~ 56
조병규, 손효정, 조맹기, 최길수, 심보성,
소속 상세정보
조병규 (  ) 
서울대학교 의과대학 신경과학교실

손효정 (  ) 
서울대학교 의과대학 신경과학교실
조맹기 ( Cho Maeng-Ki ) 
서울대학교 의과대학 신경과학교실
최길수 (  ) 
서울대학교 의과대학 신경과학교실
심보성 (  ) 
서울대학교 의과대학 신경과학교실

Abstract


The purpose of this report is to present the results of clinical observations on the surgical treatment of 26 patients (16 male, 10 female) with intractable pain during the period from May, 1960 to April, 1972 at the Department of Neurosurgery, Seoul National University. Hospital.
Age at the time of operation ranged from 27 to 69 years. Duration of the pain from the onset -to surgery was less than one year in .most of the cases.
The most common causes of the pain were the pelvic malignancies, lung- cancer, named metastatic spine tumors in the order.
In 20 cases of anterolateral cordotomies, the main complications were urinary retention, ipsilateral motor weakness, and decubitus.
The high cervical cordotomy produced high analgesic level and less dropping of established analgesic level postoperatively.
Posterior rhizotomy for intercostal neuralgia and a case of thoracic commissurotomy for intramedullary tumor were of gratifying result.
The higher the pain located, the longer the pain existed, the operation was less likely to relieve the pain.
High cervical cordotomy seems to be superior to the high thoracic cordotomy even in the pain of leg, when it is considered in the respect of the high analgesic level, the lack of "island" of pain, and technical easiness.

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