Dorsal root entry zone lesion versus spinal cord stimulation in the management of pain from brachial plexus avulsion.
In six patients with total or partial brachial plexus avulsion, spinal cord stimulation was tried as pain treatment. Two patients had had amputation of the arm and suffered from phantom limb and stump pain. After a mean follow-up of 14 months two patients were painfree, one had partial relief and required analgesics and in three patients there was no effect. In eleven patients, including the three patients in whom spinal cord stimulation had failed to produce a long-lasting pain relief, dorsal root entry zone (DREZ) lesions were performed. At early follow-ups all these patients reported substantial pain relief, but after a mean follow-up of 17 months the results were less favorable: Three patients were pain-free, three had a marked improvement and five had recurrence of the original pain. Neither of the two methods of treatment produced any serious side-effects or permanent sequelae.
Garcia-March
G
G
Departmento de Neurocirugía, Hospital Clínico Universitario, Salamanca, Spain.
Sánchez-Ledesma
M J
MJ
Diaz
P
P
Yagüe
L
L
Anaya
J
J
Gonçalves
J
J
Broseta
J
J
D000328:Adult; D001917:Brachial Plexus; D002908:Chronic Disease; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000601:surgery; D059408:Pain Management; D010523:Peripheral Nervous System Diseases / Q000150:complications / Q000601:surgery*; D013116:Spinal Cord / Q000601:surgery; D013126:Spinal Nerve Roots / Q000601:surgery*