Dorsal root entry zone lesion performed with Nd:YAG laser

Abstract

Thermocoagulation of the dorsal root entry zone (DREZ) is the current surgical management of deafferentation pain syndromes. It is usually performed with the assistance of specially designed lesion generators. We report a patient who underwent a DREZ lesion with a Nd:YAG laser as an alternative to standard thermocoagulation technique. A 62-year-old woman with a 5-year history of bilateral dysaesthetic (burning) type of leg pain, after a crush fracture of the fourth thoracic vertebra and complete cord transection, was managed by inducing a bilateral dorsal root entry zone lesion at T2-T5 myelotomes using a Nd:YAG laser, which was used as an alternative to the conventional electrically generated thermocoagulation. A significant reduction of deafferentation type of pain was achieved.

• Key Words: Cord Thermocoagulation, Deafferentation Pain, Drez, Dysaesthesia, Paraplegia.