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A modified microsurgical DREZotomy procedure for refractory neuropathic pain

Title
A modified microsurgical DREZotomy procedure for refractory neuropathic pain
Author
이형중
Keywords
Continuous; Diffuse; Microsurgical DREZotomy; Modified; Neuropathic pain; Spinal cord injury
Issue Date
2011-03
Publisher
Elsevier Science INC
Citation
World Neurosurgery, 2011, 75(3), P.551-557
Abstract
OBJECTIVE: 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. METHODS: 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. RESULTS: In 38 patients with paraplegic pain resulting from a spinal cord injury occurring within the preceding 7 years, 11 of 15 patients (73%) with a diffuse pain distribution had a good reduction in pain. Thirteen patients (86%) with continuous pain noted good pain relief. In patients with thermal pain, only one patient (20%) demonstrated a good response to the investigational procedure. CONCLUSION: These procedures, including the modified MDT technique, may be helpful in controlling paraplegic pain in patients suffering from diffuse, thermal, or continuous pain.
URI
https://www.worldneurosurgery.org/article/S1878-8750(10)01004-1/fulltext
ISSN
1878-8750
DOI
10.1016/j.wneu.2010.12.005
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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