Treatment of Postherpetic Neuralgia Using DREZotomy Guided by Spinal Cord Stimulation.

Stereotactic and functional neurosurgery

PubMedID: 25833065

Liu MX, Zhong J, Zhu J, Xia L, Dou NN. Treatment of Postherpetic Neuralgia Using DREZotomy Guided by Spinal Cord Stimulation. Stereotact Funct Neurosurg. 2015;93(3):178-81.
BACKGROUND
Postherpetic neuralgia (PHN) is the most common complication following an episode of acute herpes zoster. The curative effect of current treatments is limited.

OBJECTIVES
The purpose of this paper is to report a new treatment for PHN with a combination of dorsal root entry zone lesion (DREZotomy) and spinal cord stimulation (SCS).

METHODS
Microsurgical DREZotomy assisted with SCS for target localization was performed in 6 patients with PHN. A visual analog scale (VAS) was used to evaluate the pain pre- and postoperatively.

RESULTS
Except for 1 patient, in whom the test SCS was unsatisfactory, all patients finally underwent DREZotomy. These 5 patients experienced apparent symptom relief postoperatively, and the VAS score decreased from a baseline of 8.4 ± 1.14 to 2.4 ± 1.14 (p = 0.0020) and did not change significantly during the follow-up of up to 24 months.

CONCLUSIONS
Microsurgical DREZotomy assisted with SCS for target localization is an effective remedy for PHN. © 2015 S. Karger AG, Basel.