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Dorsal root entry zone lesions for intractable pain after trauma to the conus medullaris and cauda equina.

Publication ,  Journal Article
Sampson, JH; Cashman, RE; Nashold, BS; Friedman, AH
Published in: J Neurosurg
January 1995

This review was undertaken to determine the efficacy of using dorsal root entry zone (DREZ) lesions to treat intractable pain caused by trauma to the conus medullaris and cauda equina. Traumatic lesions of this area are unique in that both the spinal cord and the peripheral nerve roots are injured. Although DREZ lesions have been shown to relieve pain of spinal cord origin in many patients, they have been shown not to relieve pain of peripheral nerve origin. Therefore, 39 patients with trauma to the conus medullaris and cauda equina who underwent DREZ lesioning for intractable pain were reviewed retrospectively. The results of this review demonstrate the efficacy of DREZ lesions in these patients. At a mean follow-up period of 3.0 years, 54% of patients were pain-free without medications, and 20% required only nonnarcotic analgesic drugs for pain that no longer interfered with their daily activities. Better outcomes were noted in patients with an incomplete neurological deficit, with pain having an "electrical" character, and with injuries due to blunt trauma. Operative complications included weakness (four patients), bladder or sexual dysfunction (three), cerebrospinal fluid leak (two), and wound infection (two), but overall, 79.5% of patients (31 of 39) were without serious complications. Complications were limited to patients with prior tissue damage at the surgical exploration site and were most prevalent in patients who underwent bilateral DREZ lesions. In conclusion, this preliminary report suggests that DREZ lesions may be useful in combating intractable pain from traumatic injuries to the conus medullaris and cauda equina, with some risk to neurological function that may be acceptable in this group of patients.

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Published In

J Neurosurg

DOI

ISSN

0022-3085

Publication Date

January 1995

Volume

82

Issue

1

Start / End Page

28 / 34

Location

United States

Related Subject Headings

  • Spinal Nerve Roots
  • Spinal Cord Injuries
  • Pain, Intractable
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cauda Equina
  • Adult
 

Citation

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Sampson, J. H., Cashman, R. E., Nashold, B. S., & Friedman, A. H. (1995). Dorsal root entry zone lesions for intractable pain after trauma to the conus medullaris and cauda equina. J Neurosurg, 82(1), 28–34. https://doi.org/10.3171/jns.1995.82.1.0028
Sampson, J. H., R. E. Cashman, B. S. Nashold, and A. H. Friedman. “Dorsal root entry zone lesions for intractable pain after trauma to the conus medullaris and cauda equina.J Neurosurg 82, no. 1 (January 1995): 28–34. https://doi.org/10.3171/jns.1995.82.1.0028.
Sampson JH, Cashman RE, Nashold BS, Friedman AH. Dorsal root entry zone lesions for intractable pain after trauma to the conus medullaris and cauda equina. J Neurosurg. 1995 Jan;82(1):28–34.
Sampson, J. H., et al. “Dorsal root entry zone lesions for intractable pain after trauma to the conus medullaris and cauda equina.J Neurosurg, vol. 82, no. 1, Jan. 1995, pp. 28–34. Pubmed, doi:10.3171/jns.1995.82.1.0028.
Sampson JH, Cashman RE, Nashold BS, Friedman AH. Dorsal root entry zone lesions for intractable pain after trauma to the conus medullaris and cauda equina. J Neurosurg. 1995 Jan;82(1):28–34.

Published In

J Neurosurg

DOI

ISSN

0022-3085

Publication Date

January 1995

Volume

82

Issue

1

Start / End Page

28 / 34

Location

United States

Related Subject Headings

  • Spinal Nerve Roots
  • Spinal Cord Injuries
  • Pain, Intractable
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cauda Equina
  • Adult