Dorsal root entry zone lesions for treatment of pain-related to radiation-induced plexopathy.

Abstract:

STUDY DESIGN:Case series. OBJECTIVE:Presentation of results of dorsal root entry zone lesions in 10 patients suffering from severe neuropathic pain due to brachial plexopathy or radiation-induced trigeminal neuropathy. SUMMARY OF BACKGROUND DATA:Radiation-induced neuropathy is an uncommon but serious complication of radiotherapy. It may cause delayed motor and sensitive impairment associated with severe treatment-resistant pain. Various therapeutic approaches have been reported aimed at controlling radiation-induced neuropathy-pain, demonstrating poor outcomes. METHODS:Eight patients with plexopathy underwent dorsal root entry zone lesion in the cervical spinal cord, while 2 other subjects received stereotactic trigeminal nucleotractotomy. Subjects were followed prospectively before and after brachial dorsal root entry zone or trigeminal caudal operations (range 0.5-36 months). RESULTS:All patients experienced improvement in pain conditions. A total of 8 patients reported full pain relief (visual analog scale = 0) by the end of the follow-up period. The remaining patients had partial control of pain. One patient required reoperation to achieve optimal pain relief. Both patients who underwent trigeminal nucleotractotomy had transient ataxia in the ipsilateral upper limb. One of the patients treated by dorsal root entry zone lesion had minor aggravation of weakness of the ipsilateral lower limb. CONCLUSION:The present results suggest that the trigeminal nucleotractotomy and dorsal root entry zone lesions in cervical spinal cord are an effective procedure for the treatment of pain associated with actinic peripheral neuropathy.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Teixeira MJ,Fonoff ET,Montenegro MC

doi

10.1097/01.brs.0000261541.97749.e7

subject

Has Abstract

pub_date

2007-05-01 00:00:00

pages

E316-9

issue

10

eissn

0362-2436

issn

1528-1159

pii

00007632-200705010-00022

journal_volume

32

pub_type

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