Pain Relief from Dorsal Root Entry Zone(DREZ) Lesions Made with CO2 Laser in Brachial Plexus Injury Patients.

Kim, Duck Kyu; Kim, Dae Whan; Lee, Moon Tae; Han, Dong Rho; Jang, Jee Soo; Lee, Sang Goo; Lim, Chang Soo; Kim, Chung Chul

Original Article

Journal of Korean Neurosurgical Society 1994;23(7): 842-850.

Duck Kyu Kim, Dae Whan Kim, Moon Tae Lee, Dong Rho Han, Jee Soo Jang, Sang Goo Lee, Chang Soo Lim, Chung Chul Kim

Department of Neurosurgery, Korea Veterans Hospital, Seoul, Korea.

ABSTRACT

Treatment of pain related to various types of deafferentation remains a neurosurgical challenge. Medical therapy and conventional surgical techniques for pain relief have not been effective due to this problem. Six patients with intractable pain following a brachial plexus injury were treated with dorsal root entry zone(DREZ) lesions. These lesions were made with CO2 laser. All patients were followed from 5 months to 5 years after surgery. Two-third of the patients were relieved of more than 50% of their preoperative pain. Post-operative neurosurgical complications were ipsilateral leg weakness and loss of proprioception in 2 cases. The laser technique is exact, makes uniform lesion, shortens the duration of the procedure, lessens cord manipulation and makes shalow penetration into the surrounding spinal cord. Dorsal root entry zone(DREZ) lesions made with CO2 laser appeared to be a satisfactory treatment for brachial plexus injury patients who have failed to respond to more conservative modes of therapy.

Key Words: Deafferentation pain; Brachial plexus injury; Dorsal root entry zone(DREZ); CO2 laser; Complication