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ORIGINAL ARTICLE
Year : 2018  |  Volume : 5  |  Issue : 4  |  Page : 155-161

Dorsal root entry zone operation for brachial plexus neuropathic pain


Lead Consultant and Neurosurgeon Kauvery Hospital, Mylapore, Chennai, India

Correspondence Address:
G Balamurali
Lead Consultant and Neurosurgeon, Kauvery Hospital, Mylapore, Chennai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.5005/jp-journals-10039-1191

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Background: We sought to assess efficacy, pain relief, surgical morbidity, and postoperative quality of life in patients who have undergone dorsal root entry zone (DREZ) lesioning for intractable brachial plexus injury and spinal cord injury neuropathic pain. Methods: We analyzed 16 patients who underwent DREZ lesioning between 2011 and 2016 by a single surgeon. All our patient's data was analyzed on pre- and post-op visual analog scale (VAS) scores, SF12, normalized dispersion index (NDI) score, questionnaires, and outcome scores. The mean age was 48 years (31–62 years) with 15 males and 1 female. Average follow up was 3.6 years. Results: Of the 16 patients, 3 (20%) patients experienced “excellent” postoperative (complete) pain relief with another 11 (69%) reporting “good” improvement and 1 (11%) had “good” improvement. Two patients (16%) had objective evidence of a new, mild motor deficit postoperatively. All the 16 patients (100%) stated they would recommend DREZ lesioning procedure to anyone with similar symptoms. There was a statistically significant improvement in VAS scores and quality of life scores at 5 years. Five patients had objective evidence of a new, mild posterior column and motor deficit postoperatively which improved within 6 months and 87% of them did not take any medication further. Conclusion: With the appropriate patient selection, DREZ lesioning is an efficacious and durable procedure that can be performed with low morbidity and very good patient outcomes for patients with brachial plexus avulsion and spinal cord injury pain. Awareness among doctors and patients is necessary.


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