Abstract
Pain is an early symptom following avulsion of the brachial plexus in 70% of patients, but only 20% develop intractable disabling pain requiring surgical Intervention. In the past neurosurgical treatment has consisted of rhizotomy, cordotomy, dorsal column stimulation and stereotactic mesencephalotomy all of which have been largely unsuccessful 1, 2. Recently 18 patients with intractable pain from brachial plexus avulsion lesions were treated with a new surgical technique using radiofrequency coagulation of the dorsal root entry zone (DREZ) of the cervical cord in the region of the avulsed nerve root. Since the initial clinical results in the brachial plexus avulsion patients were encouraging, we have applied the treatment to three additional patients with intractable pain from other causes. These include one man with a gunshot injury to the brachial plexus, a woman suffering from a gunshot wound to the spine with involvement of the spinal word and a third man with intractable chronic pain due to a pelvic tumour.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Falconer, M. A., Surgical treatment of intractable phantom limb pain. Brit. Med. J. 1 (1953), 299–304.
Zorub, D. S., Nashold, B. S., Jr., Cook, W. A., Jr., Avulsion of the brachial plexus. I. A review with implications on the therapy of intractable pain. Surg. Neurol. 2 (1974), 347–353.
Tillman, B., Engel, H., Clinical and late pathoanatomical findings after brachial plexus avulsion. Fortschr. Neurol. Psychiatr. 42 (1974), 28–37 (Ger).
Loeser, J. D., Ward A. A., Jr., Some effects of deafferentation on neurons of the cat spinal cord. Arch. Neurol. 17 (1967), 629–636.
Loeser, J. D., Ward, A. A., Jr., White, L. E., Jr., Chronic deafferentation of human spinal cord neurons. J. Neurosurg. 29 (1968), 48–50.
Denny-Brown, D., The importance of steady-state equilibria in small-celled reticular systems. In: The Neurosciences. Paths of Discovery, pp. 295–308 (Warden, F. G., Swagery, J. P., Adelman, G., eds.). Cambridge, Mass./London: MIT Press. 1975.
Pagni, C. A., Central pain and painful anesthesia: Pathophysiology and treatment of sensory deprivation syndromes due to central and peripheral nervous system lesions. In: Progress in Neurological Surgery, Vol. 8, pp. 132–257 (Krayenbühl, H., Maspes, P. E., Sweet, W. H., eds.). Basel: S. Karger. 1976.
Ranson, S. W., The course within the spinal cord of the non-medullated fibers of the dorsal roots: A study of Lissauer’s tract in the cat. J. Comp. Neurol. 23 (1913), 259–281.
Hyndman, O. R., Lissauer’s tract section. A contribution to chordotomy for the relief of pain (preliminary report). J. Int. Coli. Surg. 5 (1942), 394–400.
Denny-Brown, D., Kirk, E. J., Yanagisawa, N., The tract of Lissauer in relation to sensory transmission in the dorsal horn of spinal cord in the macaque monkey. J. Comp. Neurol. 151 (1973), 175–199.
Kerr, F. W. L., Spinal V nucleolysis: intractable craniofacial pain. Surg. Forum 17 (1966), 419–421
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1980 Springer-Verlag
About this paper
Cite this paper
Nashold, B.S., Ostdahl, R.H. (1980). Pain Relief After Dorsal Root Entry Zone Lesions. In: Gillingham, F.J., Gybels, J., Hitchcock, E., Rossi, G.F., Szikla, G. (eds) Advances in Stereotactic and Functional Neurosurgery 4. Acta Neurochirurgica Supplementum, vol 30. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8592-6_48
Download citation
DOI: https://doi.org/10.1007/978-3-7091-8592-6_48
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-81591-5
Online ISBN: 978-3-7091-8592-6
eBook Packages: Springer Book Archive