Experience with 25 years of dorsal root entry zone lesioning at a single institution

BACKGROUND: The authors sought to assess long-term efficacy, surgical morbidity, and postoperative quality of life in patients who have undergone dorsal root entry zone (DREZ) lesioning. METHODS: We utilized the electronic chart system at our institution to identify patients who underwent DREZ lesioning since 1986. Of the patients that were able to be identified, 19 (12 males and 7 females) patients were able to be contacted at time of data collection. The mean age was 47 years (ranging from 23 to 70 years) with average preoperative pain duration of 12.5 years and average follow-up of 4.9 years. RESULTS: Of the 19 patients we were able to contact, 7 (37%) patients experienced “excellent” postoperative (complete) pain relief with another 6 (32%) reporting “good” improvement. Three (16%) patients reported “mild” pain relief, while three (16%) patients reported poor results. Sixteen patients (84%) stated they would undergo DREZ lesioning again, if given a choice. Two patients (11%) had objective evidence of a new, mild motor deficit postoperatively. More than half of the patients, who answered, reported “good” quality of life. Two-sample unequal variance t-test showed no statistically significant difference in pain improvement between brachial plexus avulsion and end-zone spinal cord injury pain. CONCLUSION: With appropriate patient selection, DREZ lesioning is an efficacious and durable procedure that can be performed with low morbidity and good patient outcomes.