Dorsal horn suction – A DREZ lesioning technique based on intrinsic cord tissue elasticity

Abstract

Aim and objectiveThe accuracy of the lesioning plays a crucial role in the results of Dorsal Root Entry Zone (DREZ) surgery. The DREZ lesioning utilizes different techniques: radiofrequency, laser, ultrasound, electrocoagulation, with the size and the shape of the lesions determined by the technical parameters of the respective technique. The aim of this study is to assess the effectiveness of the dorsal horn suctioning as a DREZ lesioning technique applied for the treatment of neuropathic pain of spinal cord and/or cauda equina injury origin. The geometry of the lesion was determined by the natural properties of the cord tissue itself. MethodsThe series of 20 patients, 18 men and 2 women, aged 24–66 years, with a mean age of 40 year were operated on using Sindou's Microsurgical DREZotomy technique, modified in such a way that the selective dorsal horn suctioning was performed as a lesioning method instead of bipolar electrocoagulation, because they suffered from chronic neuropathic pain as the sequel of spinal injuries. Success in pain relief has been defined as 50% or greater reduction in pain after surgery. ResultsSatisfactory long-term pain relief was achieved in 16 (80%) of patients.Complete long-term pain relief was achieved in 12 (60%) of the patients. ConclusionOur results confirmed the dorsal horn suction as a feasible DREZ lesioning method.