DREZotomy in the treatment of cancer pain: a review.

Stereotact Funct Neurosurg 2012 23;90(6):356-60. Epub 2012 Aug 23.

Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA.

Background: Cancer-related pain is a common problem that may be intractable by medical and neuromodulatory treatment. The dorsal root entry zone (DREZ) is a hyperactive focus in neuropathic pain syndromes, and DREZotomy has been used in selective cases of neuropathic cancer pain.

Objective: The aim of this study was to describe the technique of spinal DREZotomy in the treatment of cancer pain and review the relevant published literature.

Methods: A PubMed database search for 'DREZ', 'dorsal root entry zone' and 'cancer', and a search of the references of these manuscripts, was undertaken.

Results: 14 papers were identified and reviewed that described a total of 123 patients with cancer pain or radiation-induced pain who have been treated with DREZotomy. Though heterogeneous, these studies reported an overall favorable outcome in carefully selected patients with topographically limited pain syndromes.

Conclusion: For patients with well-localized neuropathic cancer pain intractable to medical and first-line surgical management, DREZotomy is a viable treatment option. Further prospective studies are needed to evaluate the outcomes of this procedure.

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May 2013
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