Lesions of spinal and trigeminal dorsal root entry zone for deafferentation pain. Experience of 35 cases.
Spinal and trigeminal dorsal root entry zone destruction (DREZ-tomy) was performed on 35 patients with deafferentation pain of various types. Overall, satisfactory pain relief was obtained in 65.5% of spinal DREZ-tomy cases in the follow-up observation. The result in the brachial plexus avulsion group was the best (82.4% improved), followed by the limb pain group without root avulsion (50.0%), but the truncal or visceral pain group showed the worst result (33.3%). Two patients with postherpetic trigeminal neuralgia were completely relieved of pain in the average follow-up period of 32 months, while in 2 patients with postrhizotomy facial pain, pain recurred 4 months after the operation in 1, and, in the other, pain in the medial part of the face remained unchanged. Complications were seen in about 60% of the patients, which were, however, all mild, except for 2 cases of death due to gastrointestinal disease.
Ishijima
B
B
Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Japan.
Shimoji
K
K
Shimizu
H
H
Takahashi
H
H
Suzuki
I
I
D000328:Adult; D000344:Afferent Pathways / Q000502:physiology; D000368:Aged; D001917:Brachial Plexus / Q000293:injuries* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009475:Neurons, Afferent / Q000502:physiology*; D010146:Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013126:Spinal Nerve Roots / Q000503:physiopathology / Q000601:surgery*; D014277:Trigeminal Neuralgia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D014279:Trigeminal Nucleus, Spinal / Q000503:physiopathology / Q000601:surgery