Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0026838 (spasticity)
 6,471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

At the light of authors' present experience, radicletomy appears as an excellent antalgic operative procedure in the case of roots with high functional risk (brachial plexus and lumbar plexus). In the absence of any motor deficiency or ataxia, it appears that radicletomy is of help in the cure of severe hypertonies of the extremities (sequelae of cerebral stem contusions). Conversely, in the spastic sequelae of hemi- or paraparesias, lumbar-sacral posterior selective radicotomy is a sure procedure that procures results nearly super-imposable to radicletomy with an appreciable gain in time. At last, for what concerns the motor involvements of the upper extremity ending in spasticity, selective radicletomy recovers its rights and has to be preferred to S.P.R. The indications may be summarized as follows: -- At the level of the lower extremities: in the case of paraparetic sequelae or of sequelae due to spastic paraplegia, a S.P.R. has to be performed; for what concerns antalgic surgery, in the absence of motor deficiency, the best indication is radicletomy. -- At the level of the upper extremities: in the case of dystonic sequeale of the cerebral stem, spastic pain bound with hemiplegia or with carcinoma etc. (herpes zoster..), radicletomy constitutes the ideal surgical procedure.
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PMID:[Results of selective posterior radiculetomy at the lumbar and cervical level]. 5 51

Since 1972, micro-DREZ-tomy has been performed in 367 patients: with cancer pain in 81, neurogenic pain in 139, hyperspasticity in 135, and hyperactive neurogenic bladder in 12. MDT consists of an incision and bipolar coagulations performed ventro-laterally in the Dorsal Root Entry Zone (DREZ) at the entrance of the rootlets into the dorso-lateral sulcus. The lesion is directed at 45 degrees ventro-medially, and 2-3 mm deep according to the pre-operative neurological status and the desired effects. MDT 1 degree interrupts the small (nociceptive) fibres regrouped laterally and the large (myotatic) afferents which runs centrally, whilst sparing part of the large medial (lemniscal) fibres. 2 degrees destroys the (excitatory) medial part of the Lissauer's tract, 3 degrees and the cells of the dorsalmost layers of the dorsal horn, which can be the site of hyperactivity, as we were able to record in patients with deafferentation pain. Best indications are: 1) well localized cancer pain, such as Pan-coast syndrome; 2) neuropathic pain due to: brachial plexus injuries, cauda equina and/or spinal cord lesions especially for pain corresponding to segmental lesions, peripheral nerve injuries-amputation-herpes zoster-(especially when the predominant component of pain is of the paroxysmal type and/or corresponds to provoked hyperalgesia/allodynia); 3) excess of spasticity and 4) neurogenic hyperactive bladder.
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PMID:Microsurgical DREZotomy (MDT) for pain, spasticity, and hyperactive bladder: a 20-year experience. 874 59

Microsurgical drezotomy (MDT) consists of an incision and bipolar coagulations performed ventro-laterally in the Dorsal Root Entry Zone (DREZ) at the entrance of the rootlets into the dorso-lateral sulcus. The lesion is directed at 35 ventro-medially, and to 2-3 mm deep according to the pre-operative neurological status and the desired effects. MDT i) interrupts the small (nociceptive) fibres regrouped laterally and the large (myotatic) afferents which runs centrally, whilst sparing part of the large medial (lemniscal) fibres, ii) destroys the (excitatory) medial part of the Lissauer's tract, iii) and the cells of the dorsalmost layers of the dorsal horn, which can be the site of hyperactivity, as we were able to record in patients with deafferentation pain. Best indications are: i) well-localized cancer pain, such as Pancoast syndrome; ii) neuropathic pain due to: brachial plexus injuries; cauda equina and/or spinal cord lesions (especially for pain corresponding to segmental lesions); peripheral nerve injuries, amputation, herpes zoster - especially when the predominant component of pain is of the paroxysmal type and/or corresponds to provoked hyperalgesia/allodynia); iii) excess of spasticity, especially when associated with severe pain.
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PMID:[Surgery in the dorsal root entry zone for treatment of chronic pain]. 1108 76