Success with dorsal root entry zone lesioning after a failed trial of spinal cord stimulation in a patient with pain due to brachial plexus avulsion

Abstract. Pain caused by brachial plexopathy (BP) represents a challenging clinical problem with few effective therapeutic options. Here, we present a patient with severe, painful BP after a high-impact motor vehicle accident who failed conservative treatments. A trial of cervical spinal cord stimul...

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Autores principales:	Lucia Lopez, Andrei D. Sdrulla
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/1d49e266481a41caa7aa896f79b90f8c
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spelling	oai:doaj.org-article:1d49e266481a41caa7aa896f79b90f8c2021-11-25T07:59:39ZSuccess with dorsal root entry zone lesioning after a failed trial of spinal cord stimulation in a patient with pain due to brachial plexus avulsion2471-253110.1097/PR9.0000000000000973https://doaj.org/article/1d49e266481a41caa7aa896f79b90f8c2021-11-01T00:00:00Zhttp://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000000973https://doaj.org/toc/2471-2531Abstract. Pain caused by brachial plexopathy (BP) represents a challenging clinical problem with few effective therapeutic options. Here, we present a patient with severe, painful BP after a high-impact motor vehicle accident who failed conservative treatments. A trial of cervical spinal cord stimulation was completed using multiple waveforms (tonic, BurstDR, and 10 kHz) over 14 days with only 30% to 40% pain reduction. Subsequently, he underwent dorsal root entry zone lesioning with a significant decrease in his pain 1 year later. Surgical exploration revealed extensive damage and avulsion of his cervical roots that was not observed on a previous brachial plexus magnetic resonance imaging. We discuss the etiology and diagnosis of traumatic BP, possible reasons for the failed spinal cord stimulation trial, and implications for management.Lucia LopezAndrei D. SdrullaWolters KluwerarticleAnesthesiologyRD78.3-87.3ENPAIN Reports, Vol 6, Iss 4, p e973 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Anesthesiology RD78.3-87.3
spellingShingle	Anesthesiology RD78.3-87.3 Lucia Lopez Andrei D. Sdrulla Success with dorsal root entry zone lesioning after a failed trial of spinal cord stimulation in a patient with pain due to brachial plexus avulsion
description	Abstract. Pain caused by brachial plexopathy (BP) represents a challenging clinical problem with few effective therapeutic options. Here, we present a patient with severe, painful BP after a high-impact motor vehicle accident who failed conservative treatments. A trial of cervical spinal cord stimulation was completed using multiple waveforms (tonic, BurstDR, and 10 kHz) over 14 days with only 30% to 40% pain reduction. Subsequently, he underwent dorsal root entry zone lesioning with a significant decrease in his pain 1 year later. Surgical exploration revealed extensive damage and avulsion of his cervical roots that was not observed on a previous brachial plexus magnetic resonance imaging. We discuss the etiology and diagnosis of traumatic BP, possible reasons for the failed spinal cord stimulation trial, and implications for management.
format	article
author	Lucia Lopez Andrei D. Sdrulla
author_facet	Lucia Lopez Andrei D. Sdrulla
author_sort	Lucia Lopez
title	Success with dorsal root entry zone lesioning after a failed trial of spinal cord stimulation in a patient with pain due to brachial plexus avulsion
title_short	Success with dorsal root entry zone lesioning after a failed trial of spinal cord stimulation in a patient with pain due to brachial plexus avulsion
title_full	Success with dorsal root entry zone lesioning after a failed trial of spinal cord stimulation in a patient with pain due to brachial plexus avulsion
title_fullStr	Success with dorsal root entry zone lesioning after a failed trial of spinal cord stimulation in a patient with pain due to brachial plexus avulsion
title_full_unstemmed	Success with dorsal root entry zone lesioning after a failed trial of spinal cord stimulation in a patient with pain due to brachial plexus avulsion
title_sort	success with dorsal root entry zone lesioning after a failed trial of spinal cord stimulation in a patient with pain due to brachial plexus avulsion
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/1d49e266481a41caa7aa896f79b90f8c
work_keys_str_mv	AT lucialopez successwithdorsalrootentryzonelesioningafterafailedtrialofspinalcordstimulationinapatientwithpainduetobrachialplexusavulsion AT andreidsdrulla successwithdorsalrootentryzonelesioningafterafailedtrialofspinalcordstimulationinapatientwithpainduetobrachialplexusavulsion
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Success with dorsal root entry zone lesioning after a failed trial of spinal cord stimulation in a patient with pain due to brachial plexus avulsion

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