Effect of Radiofrequency Dorsal Root Entry Zone Lesion for Neuropathic Intractable Pain.

Chae, Yu Sik; Kim, Young Soo; Cheong, Jin Hwan; Yi, Hyeong Joong; Oh, Seong Hoon; Oh, Suk Jun

Original Article

Journal of Korean Neurosurgical Society 2002;32(5): 453-457.

Yu Sik Chae, Young Soo Kim, Jin Hwan Cheong, Hyeong Joong Yi, Seong Hoon Oh, Suk Jun Oh

Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea. ksy8498@hanyang.ac.kr

ABSTRACT

OBJECTIVE
The authors report a retrospective analysis of the clinical effect of dorsal root entry zone (DREZ) lesioning for neuropathic intractable pain.
METHODS
Fourteen patients who underwent dorsal root entry zone lesioning for various types of pain between September 1995 and August 2001 were evaluated retrospectively. Eleven male and three female patients whose ages ranging from 35 to 70 were studied. According to causes of intractable pain, patients were divided into paraplegic pain(7 patients), peripheral nerve injury pain(3), cancer pain(3), phantom limb pain(1) and root avulsion pain(1). Other preoperative pain managements showed no benificial effects. The changes in painful symtoms were closely observed during follow up period. The mean follow period after operation was 32.4 months.
RESULTS
Postoperatively, the decrease in level of pain was classified into four groups : excellent, good, fair, poor. Excellent represented no pain without medication : Good, pain tolerable with non-opiate medicine ; Fair, pain tolerable with opiate medicine ; Poor, pain sustained. After operation, three patients were in excellent group, eight in good, one in fair, and two in poor. Twelve patients were in medically tolerable pain group accounting for 85.7%. There were no serious operation releated side effects.
CONCLUSION
DREZ lesioning, in our series, provided substantial pain relief and this may be considered an option in management of these types of intractable neuropathic pain.

Key Words: Dorsal root entry zone lesion; Intractable pain