Radiotime (synonym of rhizotomy - operation of transection of the roots of the spinal cord. When the front radiofonii cut the front (motor) roots, while rear - rear (sensitive). The front radiatoriu produce certain types of spastic paralysis, back - severe pain syndromes - neuralgia, tablichki crises and other

Radiotime (radicotomia; from lat. radix - the root and the Greek. tome - dissection) - transection of the roots of the spinal cord. Forster (O. Fcerster) proposed the back radiatoriu LII-III-V and SI for the treatment of spastic paralysis of the lower extremities and radiatoriu CIV-CVIII, as well as ThI for upper extremities. In some cases it was dissected everything back to the roots, retaining only separate bundles of fiber. The purpose of the operation to interrupt from outside irritating impulses that cause reflex spasm and spasmodic contraction in paralyzed muscles. Key evidence: little's disease, the effects of encephalitis, militov and spinal cord injuries. In mild cases at gunshot wounds of the spine and spinal cord were effective back radiotime in combination with meningolysis. Remote results depend on the degree of spastic phenomena in the extremities, the rate of change of the brain or spinal cord and from persistent integrated events - surgical, orthopedic, balneophizioterapevtichesky, medicamentous and targeted therapeutic exercises.
To resolve excruciating pain recommended rear radiotime. When tablicach crises used rear bilateral radiatoriu Th -VII-ThIX; in case of pain syndrome of the upper extremities within WithIII-ThI, the lower extremities - ThX-LIII. Radiatoriu also used for pain caused neudalimye tumors of the spinal cord and fatal consequences of traumas of a backbone and a spinal cord. A. G. Molotkov suggested extraparliamentary radiatoriu distal spinal ganglia before entering roots in the composition of the spinal nerves. But back radiotime in pain syndrome gives only a temporary effect and therefore not widely spread.
Back radiotime is normal laminectomy (with the opening of the Dura) III-ThII for the upper limb and ThXII-LIII to the lower limbs. Upon detection of a place of an exit of the relevant posterior roots (they are wider and thicker front) crossed and partially repetiruyut. If necessary, make a back radiatoriu and on the other side.
Back radiotime was also proposed to reduce extrapyramidal rigidity and hyperkinesis. This proposal has disappeared in connection with the application of effective stereotactic operations (see Stereotaxic method) in the basal ganglia (destruction intrauteralno thalamic nuclei). Exceptions are patients with spastic Krivoshey. In this disease apply bilateral radiatoriu both back and front of the roots CI-III with simultaneous bilateral intra - and extradural intersection of the barrel extension nerve (I. accessorius) is usually the next step after or before radiotime. Recovery and improvement was observed in 80% of patients.
The technique of the operation. Anesthesia. The patient on the belly, face down. The middle section of the skin from the outside occiput to the spinous apophysis V cervical vertebra. Laminectomy CI-IV and expansion occipital foramen by removing the rear edge of 1-1,5 cm wide for easy access to the spineI. Open the Dura mater of the spinal cord midline incision, and part of it is adjacent to the formations of the posterior fossa,- a V-shaped cut, and then open the arachnoid membrane and gradually release the cerebrospinal fluid. Upon discovery back back CI and separation from it of the vessel spine take on the hook and cross first rear, front and then the back CI. In the same way first cross back and then ventral roots WithII-III and barrel spinal part of the extension of the nerve that passes between the rear roots and dent ligament. The same operation is carried out and on the other hand. Impose deaf seam at Dura, in layers sew the wound. The second stage - bilateral neurotomy incremental nerve in the neck.