DREZ surgery on conus medullaris (after failed implantation of vascular omental graft) for treating chronic pain due to spine (gunshot) injuries

The results of DREZlesioning procedure used for the treatment of chronic in tractable pain due to deafferentation caused by gunshot injuries at the tho racolumbar (T10-L1) spine level are reported in six patients The specificity of these cases arises from the fact that all the patients u nderwent, after decompressive laminectomy, an implantation of vascularized omental graft on the injured cord segments, 4-17 months after injury. Becau se of the failure of this method, which did nor improve spinal function nor hinder the development of pain, surgery in the DREZ was performed 2-5 year s after implantation. The results of the microsurgical DREZotomy procedure in those patients, 7-12 months after the surgery were: 4 patients with comp lete pain relief and 2 patients with pain relieved of 80%. All the patients with well-confined segmental pain were completely cured.