Dorsal Root Entry Zone Lesioning for Brachial Plexus Avulsion Injuries: Case Series and Literature Review

Introduction: Brachial plexus avulsion (BPA) injuries commonly occur secondary to motor vehicle collisions, usually in the young adult population. These injuries are associated with significant morbidity, and up to 90% of patients suffer from deafferentation pain. Neuromodulation procedures can be e...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Alan Chalil, Qian Wang, Mohamad Abbass, Brendan G. Santyr, Keith W. MacDougall, Michael D. Staudt
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	brachial plexus avulsion brachial plexus injury deafferentation pain DREZotomy dorsal root entry zone lesioning neuropathic pain Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/3d57ac5ec87b4ac892a331f4f3c1d3bc
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:3d57ac5ec87b4ac892a331f4f3c1d3bc
record_format	dspace
spelling	oai:doaj.org-article:3d57ac5ec87b4ac892a331f4f3c1d3bc2021-11-17T04:40:28ZDorsal Root Entry Zone Lesioning for Brachial Plexus Avulsion Injuries: Case Series and Literature Review2673-561X10.3389/fpain.2021.749801https://doaj.org/article/3d57ac5ec87b4ac892a331f4f3c1d3bc2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpain.2021.749801/fullhttps://doaj.org/toc/2673-561XIntroduction: Brachial plexus avulsion (BPA) injuries commonly occur secondary to motor vehicle collisions, usually in the young adult population. These injuries are associated with significant morbidity, and up to 90% of patients suffer from deafferentation pain. Neuromodulation procedures can be efficacious in the treatment of refractory neuropathic pain, although the treatment of pain due to BPA can be challenging. Dorsal root entry zone (DREZ) lesioning is a classical and effective neurosurgical technique which has become underutilized in treating refractory root avulsion pain.Methods: A systematic review of the different technical nuances, procedural efficacy, and complication profiles regarding DREZ lesioning for BPA injuries in the literature is included. We also present an institutional case series of 7 patients with BPA injuries who underwent DREZ lesioning.Results: In the literature, 692 patients were identified to have undergone DREZ lesioning for pain related to BPA. In 567 patients, the surgery was successful in reducing pain intensity by over 50% in comparison to baseline (81.9%). Complications included transient motor deficits (11%) and transient sensory deficits (11%). Other complications including permanent disability, cardiovascular complications, infections, or death were rare (<1.9%). In our case series, all but one patient achieved >50% reduction in pain intensity, with the mean pre-operative pain of 7.9 ± 0.63 (visual analog scale) reduced to 2.1 ± 0.99 at last follow-up (p < 0.01).Conclusion: Both the literature and the current case series demonstrate excellent pain severity reduction following DREZ ablation for deafferentation pain secondary to BPA.Alan ChalilQian WangMohamad AbbassBrendan G. SantyrKeith W. MacDougallMichael D. StaudtMichael D. StaudtFrontiers Media S.A.articlebrachial plexus avulsionbrachial plexus injurydeafferentation painDREZotomydorsal root entry zone lesioningneuropathic painNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Pain Research, Vol 2 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	brachial plexus avulsion brachial plexus injury deafferentation pain DREZotomy dorsal root entry zone lesioning neuropathic pain Neurology. Diseases of the nervous system RC346-429
spellingShingle	brachial plexus avulsion brachial plexus injury deafferentation pain DREZotomy dorsal root entry zone lesioning neuropathic pain Neurology. Diseases of the nervous system RC346-429 Alan Chalil Qian Wang Mohamad Abbass Brendan G. Santyr Keith W. MacDougall Michael D. Staudt Michael D. Staudt Dorsal Root Entry Zone Lesioning for Brachial Plexus Avulsion Injuries: Case Series and Literature Review
description	Introduction: Brachial plexus avulsion (BPA) injuries commonly occur secondary to motor vehicle collisions, usually in the young adult population. These injuries are associated with significant morbidity, and up to 90% of patients suffer from deafferentation pain. Neuromodulation procedures can be efficacious in the treatment of refractory neuropathic pain, although the treatment of pain due to BPA can be challenging. Dorsal root entry zone (DREZ) lesioning is a classical and effective neurosurgical technique which has become underutilized in treating refractory root avulsion pain.Methods: A systematic review of the different technical nuances, procedural efficacy, and complication profiles regarding DREZ lesioning for BPA injuries in the literature is included. We also present an institutional case series of 7 patients with BPA injuries who underwent DREZ lesioning.Results: In the literature, 692 patients were identified to have undergone DREZ lesioning for pain related to BPA. In 567 patients, the surgery was successful in reducing pain intensity by over 50% in comparison to baseline (81.9%). Complications included transient motor deficits (11%) and transient sensory deficits (11%). Other complications including permanent disability, cardiovascular complications, infections, or death were rare (<1.9%). In our case series, all but one patient achieved >50% reduction in pain intensity, with the mean pre-operative pain of 7.9 ± 0.63 (visual analog scale) reduced to 2.1 ± 0.99 at last follow-up (p < 0.01).Conclusion: Both the literature and the current case series demonstrate excellent pain severity reduction following DREZ ablation for deafferentation pain secondary to BPA.
format	article
author	Alan Chalil Qian Wang Mohamad Abbass Brendan G. Santyr Keith W. MacDougall Michael D. Staudt Michael D. Staudt
author_facet	Alan Chalil Qian Wang Mohamad Abbass Brendan G. Santyr Keith W. MacDougall Michael D. Staudt Michael D. Staudt
author_sort	Alan Chalil
title	Dorsal Root Entry Zone Lesioning for Brachial Plexus Avulsion Injuries: Case Series and Literature Review
title_short	Dorsal Root Entry Zone Lesioning for Brachial Plexus Avulsion Injuries: Case Series and Literature Review
title_full	Dorsal Root Entry Zone Lesioning for Brachial Plexus Avulsion Injuries: Case Series and Literature Review
title_fullStr	Dorsal Root Entry Zone Lesioning for Brachial Plexus Avulsion Injuries: Case Series and Literature Review
title_full_unstemmed	Dorsal Root Entry Zone Lesioning for Brachial Plexus Avulsion Injuries: Case Series and Literature Review
title_sort	dorsal root entry zone lesioning for brachial plexus avulsion injuries: case series and literature review
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/3d57ac5ec87b4ac892a331f4f3c1d3bc
work_keys_str_mv	AT alanchalil dorsalrootentryzonelesioningforbrachialplexusavulsioninjuriescaseseriesandliteraturereview AT qianwang dorsalrootentryzonelesioningforbrachialplexusavulsioninjuriescaseseriesandliteraturereview AT mohamadabbass dorsalrootentryzonelesioningforbrachialplexusavulsioninjuriescaseseriesandliteraturereview AT brendangsantyr dorsalrootentryzonelesioningforbrachialplexusavulsioninjuriescaseseriesandliteraturereview AT keithwmacdougall dorsalrootentryzonelesioningforbrachialplexusavulsioninjuriescaseseriesandliteraturereview AT michaeldstaudt dorsalrootentryzonelesioningforbrachialplexusavulsioninjuriescaseseriesandliteraturereview AT michaeldstaudt dorsalrootentryzonelesioningforbrachialplexusavulsioninjuriescaseseriesandliteraturereview
_version_	1718425982774280192

Dorsal Root Entry Zone Lesioning for Brachial Plexus Avulsion Injuries: Case Series and Literature Review

Ejemplares similares