Vol.3, No 12, 2002 pp. 465-468
LETTERS TO EDITOR

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THE VACUUM TECHNIQUE IN THE SPINAL SURGERY
Dušan Mikičić¹, Milan Spaić^2
1Faculty of Electrical Engineering, Belgrade,
Bul. Kralja Aleksandra 73, 11000 Beograd Yugoslavia
E-mail: mikicic@kondor.etf.bg.ac.yu
²Military Medical Academy, Department for Neurology, Belgrade

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Mechanical injuries of the spinal column and the spinal cord (medulla spinalis) are the reason for surgery interventions on the spine - the spinal surgery. However, there are cases when it is necessary to make the surgical interventions on the healthy spine in order to remove the remaining neurogenic ache due to the injury of other organs. DREZ (Dorsal Root Entry Zone) surgery is a practical method for the successful treatment of the central neurogenic ache. The surgeon makes the controlled destruction of a sensitive nerve of the last horn of the gray mass of the medulla. In such a way it stops sending painful pulses from the injured place through the spine to the brain. In surgical practice dominates the thermal destruction (radiofrequencial, ultrasound, laser - techniques), where a permanent lesion is achieved at the temperatures t>=45^oC [1]. This paper will present the vacuum technique for making mechanical destruction of a sensitive nerve of the gray mass. This technique has been used in the course of several years by neurosurgeon M. Spaic at MMA in Belgrade [1]. This technique is already highly evaluated by well-known surgeons [1] as it is simple, cheap with almost the same risk of success.

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VAKUUMSKA TEHNIKA U SPINALNOJ HIRURGIJI Mehaničke povrede kimčmenog stuba i kičmene moždine (medula spinalis) su razlog hirurške intervencije na kičmi - spinalna hirurgija. Medjutiim ima slučajeva kada je potrebno obaviti hiruršku intervenciju na zdravoj kičmi u cilju eliminisanja zaostalog neurogenog bola zbog povrede drugih organa. DREZ (Dorsal Root Entry Zone) hirurgija je jedna praktična metoda uspešnog lečenja centralnog neurogenog bola. Lekar hirurg vrši kontrolisanu destrukciju senzitivnog nerva zadnjeg roga sive mase medule. Na taj način prekida slanje bolnih impulsa od povredjenog mesta preko kičme do mozga. U hirurškoj praksi dominira toplotna destrukcija (radiofrekventna, ultrazvučna, laserka – tehnika), pri kojoj se permanentna lezija postiže na temperaturama t >= 450^oC [1]. U našem radu biće prikazana vakumska tehnika, kojom se vrši mehanička destrukcija senzitivnog nerva sive mase. Ovu tehniku već više godina koristi neurohirurg M. Spaić na VMA u Beogradu [1]. Ova tehika je već dobro ocenjena od strane poznatih hirurga [1], jer je jednostavna, jeftina uz približo isti rizik uspešnosti.