Chronic Pain Management
A Modified Microsurgical DREZotomy Procedure for Refractory Neuropathic Pain
Chun H-J, Kim YS, Yi H-J (Hanyang Univ Med Ctr, Seoul, Korea) World Neurosurg 75:551-557, 2011§
Control of neuropathic pain secondary to spinal cord injury is difficult; microsurgical DREZotomy (MDT) is the currently preferred treatment modality. According to previous reports, traditional MDT has poor outcomes when addressing diffuse (infralesional), thermal, and continuous pain. Here, we report improvements in surgical outcomes in these neuropathic pain conditions using a modified MDT technique.
Patients with segmental, mechanical, or intermittent pain underwent MDT using the traditional (Sindou’s) technique performed at the indicated cord level based on pain distribution. Patients suffering from diffuse, thermal, or continuous pain underwent a modified MDT procedure in the “lump“ and “irritative“ zones, as well as another procedure, whereby an attempt was made to cut every injured and fused rootlet.