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Ablative spinal cord surgery for the treatment of chronic pain

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Abstract

Percutaneous cordotomy can be a successful short-term procedure if performed by an experienced neurosurgeon. The procedure should be reserved for patients with intractable pain secondary to malignant disease that is resistant to conservative treatment and pain that is not of a dysesthetic type. Dorsal root entry zone (DREZ) lesions can be highly effective in eliminating certain previously intractable pain syndromes by eliminating the pathologic discharge of neurons in the dorsal horn following injury. DREZ surgery is of proven value in treating pain following brachial plexus avulsion injury and certain pain syndromes following spinal cord injury. DREZ lesions are less effective in treating postherpetic pain along with a higher prevalence of postoperative neurologic deficits, which may be due to the advanced age of patients suffering from this condition. This article reviews various aspects of anterolateral cordotomy and DREZ lesioning.

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  1. Allan H. Friedman
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  2. Alan Villavicencio
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Friedman, A.H., Villavicencio, A. Ablative spinal cord surgery for the treatment of chronic pain. Curr Pain Headache Rep 1, 223–237 (1997). https://doi.org/10.1007/BF02938170

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