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 NI SPECIAL FEATURE: OPERATIVE NUANCES: STEP BY STEP (VIDEO SECTION)
Year : 2020  |  Volume : 68  |  Issue : 5  |  Page : 1012--1015

Dorsal Root Entry Zone (DREZ) Lesioning for Brachial Neuralgia


Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Dr. Deepak Agrawal
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi - 110 029
India
Ramesh S Doddamani
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.299139

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Background and Introduction: Patients with brachial plexus avulsion (BPA) injuries often suffer from chronic disabling drug refractory neuropathic pain. Dorsal root entry zone (DREZ) lesioning is currently the most effective surgical procedure for this intractable brachial neuralgia following BPA. Objective: To demonstrate a novel technique of “Micro-scissor DREZotomy” developed at our institution. Procedure: A 55-year-old gentleman underwent right cervical microscissor DREZotomy for post BPA neuralgia. Exclusive use of microscissors along the posterolateral sulcus, causing mechanical disruption of the nociceptive pathways through sharp dissection, results in precise lesioning with excellent pain free outcomes. Results: The patient had complete relief of the pain and uneventful recovery following the surgery and remains to be pain free at 1 year follow up. Conclusion: Microscissor DREZotomy is a simple cost-effective technique. It can easily be performed in the peripheral centers with limited resources and is a safe and effective technique in experienced hands.






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