Pain Relief After Dorsal Root Entry Zone Lesions
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.
KeywordsPain Relief Brachial Plexus Gunshot Wound Intractable Pain Avulsion Injury
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