Lesion of dorsal root entry zone for pain due to spinal cord and cauda equina injuries

Abstract

Objective To discuss the neurosurgical management for chronic neuropathic pain due to spinal cord and cauda equina injuries. Methods There were 14 patients of chronic neuropathic pain due to spinal cord and cauda equina injuries. The age was between 28 to 72 yrs old. The history was between 8 months to 28 years. The distribution of pain was confined to hypoesthetic and anesthetic areas. Pain was often described as severe burning, crushing or cramping in character. The Visual Analogy Seale was between 8 to 10. They all had complete or incomplete paraplegia. A total of 15 microsurgical dorsal root entry zoneotomy were performed on these patients. Results Postoperative follow - up were 3 months to 3 years. Six patients were free of pain with complete withdrawal of narcotics. Five patients had great pain relief whose VAS was 2 to 4. Among them, 3 were free of narcotics, 2 reduced the dose of narcotics. Three were inefficient. No severe complications occurred. Conclusion Microsurgical dorsal root entry zoneotomy was effective for treating chronic neuropathic pain due to spinal cord and cauda equina injuries. Key words: Dorsal root entry zone; Chronic neuropathic pain; Spinal cord injury; Neurosurgical procedures