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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Dorsal root entry zone coagulation (DREZ) for treatment of deafferentation pain in cervical root avulsion : long-term results and patient satisfaction

Dorsal root entry zone Koagulation (DREZ) zur Behandlung von Deafferentierungsschmerzen nach zervikalem Wurzelausriß : Langzeitergebnisse und Patientenzufriedenheit

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  • corresponding author K. Mohr - Neurosurgical Clinic University of Ulm, Günzburg
  • F. Hübner - Neurosurgical Clinic University of Ulm, Günzburg
  • K. Seitz - Neurosurgical Clinic University of Ulm, Günzburg
  • H.-P. Richter - Neurosurgical Clinic University of Ulm, Günzburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-09.06

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0036.shtml

Published: May 4, 2005

© 2005 Mohr et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

Ablative procedures in the treatment of chronic pain states such as deafferentation pain remain still controversial with regard to possible disabling complications and permanent pain control. Aim of this study was to assess long-term results and patient satisfaction of dorsal root entry zone coagulation according to Nashold.

Methods

Between 1985 and 2004 62 patients with medically refractory deafferentation pain due to cervical root avulsion were treated by dorsal root entry zone coagulation according to Nashold. Lesions were made at 75° C for 15 seconds every 1mm from the uppermost to the lowest intact rootlet in the posterolateral sulcus. 48 patients with postoperative follow-up of at least 2 years (range 2-19 y) were sent a questionnaire assessing VAS (Visual Analogue Scale) - scores, distribution and quality of pain, additional pain medication, postoperative neurological deficits and patient satisfaction. 2 patients were lost to follow-up, 34 patients (70%) were available for review.

Results

29 patients (85%) reported subjective success with at least 50% permanent pain reduction. VAS -scores (0= no pain, 10= maximum pain) dropped to 0 in 8 cases (23,5%), to 1-2 in 6 cases (17,6%) and remained at 7-8 in 3 patients (8,8%) and 9-10 in 5 patients (14,7%). New neurological deficits occurred in 9 patients (26%), including central leg paresis (1case), gait disturbance (4cases), long tract sensory loss (2cases) and different pain patterns (2cases). 79% of the patients (27) would undergo the procedure again.

Conclusions

Dorsal root entry zone coagulation seems to be a useful tool in the treatment of deafferentation pain due to cervical root avulsion if medical polyanalgetic treatment fails. The procedure can offer a very good quality of pain reduction and therefore patient-acceptance is high.