Radio Frequency Ablation
DREZ thermocoagulation remains the best evidence-based treatment for deafferentation pain. Cervical DREZ radiofrequency thermocoagulation remains a safe and highly effective operation for patients suffering from chronic pain from cervical nerve root avulsions and phantom limb pain. Nucleus caudalis DREZ has proven effective for medically-intractable facial pain syndromes including post-herpetic neuralgia, brainstem infarct-related facial pain, anesthesia dolorosa, facial pain due to multiple sclerosis, and cancer-related facial pain.
Cervical and thoracic spinal cord DREZ was pioneered at Duke in the 1960’s for patients with spinal cord injury and was used extensively for many pain disorders at that time. Over time this was found to be very effective for a few indications including transitional zone pain from a complete spinal cord injury or a brachial plexus avulsion. Due to the fact that this is an ablative, non-reversible procedure this is a treatment reserved for those patient who have tried all other possible medical or conservative treatments.