Microsurgical Drezotomy for Neuropathic Pain after Spinal Cord Injury: Long Term Results in a Patient
Published
Aug 14, 2012
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Abstract
70 % of patients with spinal cord injuries are chronic and disabling neuropathic pain. This article presents the 23 years-old patient case, who suffered an infrasegmentary severe pain by spinal cord trauma. We performed neurosurgical treatment of pain. Drezotomy is selective section of nociceptive fibers in the spinal segments involved. The patient has 24 months of complete improvement and discontinuation of analgesics.
Keywords
dolor, neuralgia, dolor intratable, Pain, neuralgia, pain intractable,
References
1. Siddall P. Management of neuropathic pain following spinal cord injury: now and in the future. Spinal Cord. 2009;47:352-9.
2. Taira T. Ablative neurosurgical procedure for pain after spinal cord injury. World Neurosurg. 2010;75(3/4):449-50.
3. O’Connor AB, Dworkin RH. Treatment of neuropathic pain: an overview of recent guidelines. Am J Med. 2009;122:S22-32.
4. Acevedo JC. Avances fisiopatológicos para el entendimiento de la lesión medular traumática [revisión bibliográfica]. Rev Col Or Tra. 2008;22(4):272-81.
5. McKinley WO, Seel RT, Gadi RK, Tewksbury MA. Nontraumatic vs. traumatic spinal cord injury: a rehabilitation outcome comparison. Am J Phys Med Rehabil. 2001;80:693-99.
6. Mazaira J, Labanda F, Romero J, García ME, Gambarruta C, Sánchez A. Epidemiología de la lesión medular y otros aspectos. Rehabilitación (Madrid). 19989;32:365-72.
7. Finnerup NB. Neuropathic pain following spinal cord injury pain: mechanisms and treatment. Scandinavian Journal of Pain. 2009;1:S3-S11.
8. Ruiz-Juretschke F. Treatment of neuropathic deafferentation pain using DREZ lesions; long-term results. Neurología. 2001;26(1):26-31.
9. Sindou M. Microsurgical drezotomy for pain due to spinal cord and/or cauda equina injuries: long-term results in a series of 44 patients. Pain. 2001;92:159-71.
10. Sindou M. Surgery in the DREZ for refractory neuropathic pain after spinal cord/cauda equina injury. World Neurosurg. 2011;75(3/4):447-8.
11. Spaic M. Microsurgical drezotomy for pain of spinal cord and cauda equina injury origin: clinical characteristics of pain and implications for surgery in a series of 26 patients. Acta Neurochir (Wien). 2002;144:453-6.
12. Chen HJ, Tu YK. Long term follow-up results of dorsal root entry zone lesions for intractable pain after brachial plexus avulsion injuries. Acta Neurochir. 2006; Suppl 99:73-5.
13. Falci S, Best L, Bayles R, Lammertse D, Starnes C. Dorsal root entry zone microcoagulation for spinal cord injuryrelated central pain: operative intramedullary electrophysiological guidance and clinical outcome. J Neurosurg. 2002;97(2 Suppl):193-200.
14. Acevedo JC. La drezotomía en el tratamiento del dolor crónico: análisis crítico de una serie de 40 pacientes tratados con cirugía. Dolor. 2009;2(1):36-45.
15. Sekhon A. Epidemiology, demographic, and pathophysiology of acute spinal cord injury. Spine. 2001;26:S2-S12.
16. Siddall PJ, Yezierski RP, Loeser JD. Pain following spinal cord injury: clinical features, prevalence, and taxonomy. Technical Corner IASP Newsletter. 2000;(3).
17. Henao-Lema CP, Pérez-Parra JE. Modelo predictivo del grado de discapacidad en adultos con lesión medular: resultados desde el Who-Das II. Rev Cienc Salud. 2011;9(2):159-72.
18. Hains BC, Everhart AE, Fullwood SD, Hulsebosch CE. Changes in serotonin, serotonin transporter expression and serotonin denervation supersensitivity: involvement in chronic central pain after spinal hemisection in the rat. Exp Neurol. 2002;175:347-62.
19. Mills CD, Johnson KM, Hulsebosch CE. Group I metabotropic glutamate receptors in spinal cord injury: roles in neuroprotection and the development of chronic central pain. J Neurotrauma. 2002;19:23-42.
2. Taira T. Ablative neurosurgical procedure for pain after spinal cord injury. World Neurosurg. 2010;75(3/4):449-50.
3. O’Connor AB, Dworkin RH. Treatment of neuropathic pain: an overview of recent guidelines. Am J Med. 2009;122:S22-32.
4. Acevedo JC. Avances fisiopatológicos para el entendimiento de la lesión medular traumática [revisión bibliográfica]. Rev Col Or Tra. 2008;22(4):272-81.
5. McKinley WO, Seel RT, Gadi RK, Tewksbury MA. Nontraumatic vs. traumatic spinal cord injury: a rehabilitation outcome comparison. Am J Phys Med Rehabil. 2001;80:693-99.
6. Mazaira J, Labanda F, Romero J, García ME, Gambarruta C, Sánchez A. Epidemiología de la lesión medular y otros aspectos. Rehabilitación (Madrid). 19989;32:365-72.
7. Finnerup NB. Neuropathic pain following spinal cord injury pain: mechanisms and treatment. Scandinavian Journal of Pain. 2009;1:S3-S11.
8. Ruiz-Juretschke F. Treatment of neuropathic deafferentation pain using DREZ lesions; long-term results. Neurología. 2001;26(1):26-31.
9. Sindou M. Microsurgical drezotomy for pain due to spinal cord and/or cauda equina injuries: long-term results in a series of 44 patients. Pain. 2001;92:159-71.
10. Sindou M. Surgery in the DREZ for refractory neuropathic pain after spinal cord/cauda equina injury. World Neurosurg. 2011;75(3/4):447-8.
11. Spaic M. Microsurgical drezotomy for pain of spinal cord and cauda equina injury origin: clinical characteristics of pain and implications for surgery in a series of 26 patients. Acta Neurochir (Wien). 2002;144:453-6.
12. Chen HJ, Tu YK. Long term follow-up results of dorsal root entry zone lesions for intractable pain after brachial plexus avulsion injuries. Acta Neurochir. 2006; Suppl 99:73-5.
13. Falci S, Best L, Bayles R, Lammertse D, Starnes C. Dorsal root entry zone microcoagulation for spinal cord injuryrelated central pain: operative intramedullary electrophysiological guidance and clinical outcome. J Neurosurg. 2002;97(2 Suppl):193-200.
14. Acevedo JC. La drezotomía en el tratamiento del dolor crónico: análisis crítico de una serie de 40 pacientes tratados con cirugía. Dolor. 2009;2(1):36-45.
15. Sekhon A. Epidemiology, demographic, and pathophysiology of acute spinal cord injury. Spine. 2001;26:S2-S12.
16. Siddall PJ, Yezierski RP, Loeser JD. Pain following spinal cord injury: clinical features, prevalence, and taxonomy. Technical Corner IASP Newsletter. 2000;(3).
17. Henao-Lema CP, Pérez-Parra JE. Modelo predictivo del grado de discapacidad en adultos con lesión medular: resultados desde el Who-Das II. Rev Cienc Salud. 2011;9(2):159-72.
18. Hains BC, Everhart AE, Fullwood SD, Hulsebosch CE. Changes in serotonin, serotonin transporter expression and serotonin denervation supersensitivity: involvement in chronic central pain after spinal hemisection in the rat. Exp Neurol. 2002;175:347-62.
19. Mills CD, Johnson KM, Hulsebosch CE. Group I metabotropic glutamate receptors in spinal cord injury: roles in neuroprotection and the development of chronic central pain. J Neurotrauma. 2002;19:23-42.
How to Cite
Acevedo González, J. C., López Cárdenas, G. V., Berbeo Calderón, M. E., Zorro Guio, Óscar, Díaz Orduz, R. C., & Feo Lee, Óscar. (2012). Microsurgical Drezotomy for Neuropathic Pain after Spinal Cord Injury: Long Term Results in a Patient. Universitas Medica, 54(2), 268–281. https://doi.org/10.11144/Javeriana.umed54-2.dcte
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Case Reports