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R K Mishra, C Mahajan, A Bindra, K Goyal
Postoperative visual loss (POVL) is a rare but grave postoperative complication. It has been mainly reported in patients undergoing cardiac and spinal surgeries. Dorsal root entry zone (DREZ) is pain relieving procedure performed in patients with refractory neuropathic pain with minimal complication rate. We present a case of unilateral POVL following DREZ rhizotomy in prone position in a patient having brachial plexus neuropathy. Exact etiology of vision loss was though not clear; hypotension, use of vasopressors and hemodilution may have led to vision loss in this patient...
October 2016: Saudi Journal of Anaesthesia
Di Wu, Michelle C Klaw, Nikolai Kholodilov, Robert E Burke, Megan R Detloff, Marie-Pascale Côté, Veronica J Tom
While the peripheral branch of dorsal root ganglion neurons (DRG) can successfully regenerate after injury, lesioned central branch axons fail to regrow across the dorsal root entry zone (DREZ), the interface between the dorsal root and the spinal cord. This lack of regeneration is due to the limited regenerative capacity of adult sensory axons and the growth-inhibitory environment at the DREZ, which is similar to that found in the glial scar after a central nervous system (CNS) injury. We hypothesized that transduction of adult DRG neurons using adeno-associated virus (AAV) to express a constitutively-active form of the GTPase Rheb (caRheb) will increase their intrinsic growth potential after a dorsal root crush...
2016: Frontiers in Molecular Neuroscience
Milan Spaic
INTRODUCTION: Chronic neuropathic pain in traumatic paraplegia appears as the illness by itself, and it represents the unique treatment challenge. The dorsal horn, an anatomical structure involved in pain generating, has been recognized as a target for ablative dorsal root entry zone (DREZ) surgery. The dorsal horn suction technique as the DREZ lesioning method takes advantage of the natural difference in dynamical viscosity of the cord white vs gray matter to perform DREZ lesions by using the suction of the dorsal horn gray matter...
August 2016: Neurosurgery
Marc Sindou, George Georgoulis
BACKGROUND: Focal dystonia in hemiplegic upper limbs is poorly responsive to medications or classical neurosurgical treatments. Only repeated botulinum toxin injections show efficacy, but in most severe cases effects are transient. OBJECTIVES: Cervical DREZ lesioning, which has proven efficacious in hyperspasticity when done deeply (3-5 mm) in the dorsal horn, may have favorable effects on the dystonic component when performed down to, and including, the base of the ventral horn (5-6 mm in depth)...
2016: Stereotactic and Functional Neurosurgery
Andrew M Garrett, Thomas J Jucius, Liam P R Sigaud, Fu-Lei Tang, Wen-Cheng Xiong, Susan L Ackerman, Robert W Burgess
Boundary cap cells (BCC) are a transient, neural-crest-derived population found at the motor exit point (MEP) and dorsal root entry zone (DREZ) of the embryonic spinal cord. These cells contribute to the central/peripheral nervous system (CNS/PNS) boundary, and in their absence neurons and glia from the CNS migrate into the PNS. We found Netrin5 (Ntn5), a previously unstudied member of the netrin gene family, to be robustly expressed in BCC. We generated Ntn5 knockout mice and examined neurodevelopmental and BCC-related phenotypes...
2016: Frontiers in Molecular Neuroscience
Andrew L Ko, Alp Ozpinar, Jeffrey S Raskin, Stephen T Magill, Ahmed M Raslan, Kim J Burchiel
OBJECT Lesioning of the dorsal root entry zone (DREZotomy) is an effective treatment for brachial plexus avulsion (BPA) pain. The role of preoperative assessment with MRI has been shown to be unreliable for determining affected levels; however, it may have a role in predicting pain outcomes. Here, DREZotomy outcomes are reviewed and preoperative MRI is examined as a possible prognostic factor. METHODS A retrospective review was performed of an institutional database of patients who had undergone brachial plexus DREZ procedures since 1995...
May 2016: Journal of Neurosurgery
Tao Fan, XinGang Zhao, HaiJun Zhao, Cong Liang, YinQian Wang, QiFei Gai, Fangyi Zhang
OF BACKGROUND DATA: It is well established that syringomyelia can cause neurological symptoms and deficit by accumulation of fluid within syrinx cavities that lead to internal compression within the spinal cord. When other intervention treating the underlying etiology failed to yield any improvement, the next option would be a procedure to divert the fluid from the syrinx cavity, such as syringo-subarachnoid, syringo-peritoneal or syringo-pleural shunting. The indications and long term efficacy of these direct shunting procedures are still questionable and controversial...
October 2015: Clinical Neurology and Neurosurgery
Byung-Chul Son, Sang-Woo Ha
BACKGROUND: Dorsal root entry zone (DREZ) lesioning has been reported to be effective for phantom limb pain caused by brachial plexus avulsion pain. Most reports on DREZ lesioning for brachial plexus avulsion pain have focused on the results of pain relief without a detailed description of phantom sensations following DREZ lesioning. MATERIALS AND METHODS: Two patients (1 with amputation and the other nonamputated) with chronic intractable phantom limb pain caused by brachial plexus avulsion underwent DREZ lesioning on the avulsed segments of the cervical spinal cords...
2015: Stereotactic and Functional Neurosurgery
Srinivas Chivukula, Zachary J Tempel, Ching-Jen Chen, Samuel S Shin, Abhiram V Gande, John J Moossy
BACKGROUND: The role for nucleus caudalis (NC) and spinal dorsal root entry zone (DREZ) lesioning in the management of chronic pain emanating from increased electrical activity in the dorsal horn of the spinal cord and brainstem remains largely uncharted. METHODS: All patients who underwent NC and spinal DREZ lesioning by a single surgeon were identified and follow-up was obtained by telephone questionnaires. Patient demographics, surgical details, outcomes, and complications were critically reviewed for all patients identified...
August 2015: World Neurosurgery
M Atarod, T E Ludwig, C B Frank, T A Schmidt, N G Shrive
OBJECTIVE: To assess ovine synovial fluid (oSF) from different post-injury time points for (1) proteoglycan-4 (PRG4) and hyaluronan (HA) concentration, (2) HA molecular weight (MW) distribution, (3) cartilage boundary lubrication function, and (4) lubricant composition-function relationships. The association between cartilage boundary lubrication and gross cartilage changes after injury was also examined. METHODS: oSF was collected 2, 4, 10, and 20 weeks post anterior cruciate ligament (ACL) transection in five skeletally mature sheep...
April 2015: Osteoarthritis and Cartilage
Pavel Haninec, Radek Kaiser, Libor Mencl, Petr Waldauf
BACKGROUND: Despite high success rate of DREZ lesioning in the treatment of intractable central pain, there is still a significant incidence of patients without satisfactory post-operative effect. The aim of the study was to evaluate the long-term effect of DREZ lesioning using both a subjective assessment using a visual analog scale (VAS) to quantify residual pain and an assessment using the screening tool (painDETECT Questionnaire, PD-Q). METHODS: DREZ lesioning was performed in 52 patients from a total 441 cases with brachial plexus injury (11...
2014: BMC Neurology
Erhan Turkoglu, Hayri Kertmen, Kutluay Uluc, Erinc Akture, Bora Gurer, Ulaş Cikla, Shahriar Salamat, Mustafa K Başkaya
The aim of this study was to analyze the topographical anatomy of the dorsal spinal cord (SC) in relation to the posterior median septum (PMS). This included the course and variations in the PMS, and its relationship to and distance from other dorsal spinal landmarks. Microsurgical anatomy of the PMS was examined in 12 formalin-fixed adult cadaveric SCs. Surface landmarks such as the dorsal root entry zone (DREZ), the denticulate ligament, the architecture of the leptomeninges and pial vascular distribution were noted...
January 2015: Clinical Anatomy
Yi-Chieh Hung, Cheng-Chia Lee, Kang-Du Liu, Wen-Yuh Chung, David Hung-Chi Pan, Huai-Che Yang
OBJECT: The authors evaluated individual anatomical variations in the trigeminal nerves of patients with medically intractable trigeminal neuralgia and clarified the relationships among the variations, radiosurgical target locations, and the clinical outcomes after high-dose Gamma Knife surgery (GKS). METHODS: From 2006 through 2011, the authors conducted a retrospective review of 106 cases of primary or secondary trigeminal neuralgia consecutively treated with GKS targeting the dorsal root entry zone (DREZ) for which a maximal dose of 90 Gy and a 20% isodose line to the brainstem were used...
December 2014: Journal of Neurosurgery
Ozlem Kirazli, Necati Tatarli, Bülent Güçlü, Davut Ceylan, Ibrahim Ziyal, Evren Keleş, Safiye Cavdar
BACKGROUND: The posterolateral sulcus (PLS) is an important surgical landmark, especially for DREZ (dorsal root entry zone) operations. METHODS: The present study aimed to show the variations of the PLS using human spinal cord histological sections and report the variability in the number of dorsal rootlets of the spinal nerves in each the spinal cord segment. Further, measure the height and width of the dorsal horn on histological sections for cervical, thoracic, and lumbar levels...
December 2014: Acta Neurochirurgica
Fei Yang, Chen Zhang, Qian Xu, Vinod Tiwari, Shao-Qiu He, Yun Wang, Xinzhong Dong, Louis P Vera-Portocarrero, Paul W Wacnik, Srinivasa N Raja, Yun Guan
OBJECTIVES: Recent clinical studies suggest that neurostimulation at the dorsal root entry zone (DREZ) may alleviate neuropathic pain. However, the mechanisms of action for this therapeutic effect are unclear. Here, we examined whether DREZ stimulation inhibits spinal wide-dynamic-range (WDR) neuronal activity in nerve-injured rats. MATERIALS AND METHODS: We conducted in vivo extracellular single-unit recordings of WDR neurons in rats after an L5 spinal nerve ligation (SNL) or sham surgery...
January 2015: Neuromodulation: Journal of the International Neuromodulation Society
Y A Chelyshev, Y O Muhamedshina, T V Povysheva, G F Shaymardanova, A A Rizvanov, M V Nigmetzyanova, O V Tiapkina, N I Bondarenko, E E Nikolskiy, R R Islamov
Exposure to microgravity has been shown to result in damaging alterations to skeletal muscle, bones, and inner organs. In this study, we investigated the effects of microgravity by using a hindlimb unloading model (HUM) in mice. The characteristics of the lumbar spinal cords of HUM mice 30 days after hindlimb unloading were examined. Morphometric analysis showed reductions of the total area, gray matter, and white matter by 17%, 20%, and 12%, respectively. Myelinated fibers in the white matter showed prominent myelin destruction...
November 7, 2014: Neuroscience
D L Gollehon, D Drez
ABSTRACT; Arthroscopic visualization of the ankle is outlined, with particular attention to establishment of portals.
September 1, 1983: Orthopedics
D Drez
No abstract text is available yet for this article.
June 1, 1982: Orthopedics
C-L Lin, P Heron, S R Hamann, G M Smith
Successful regeneration after injury requires either the direct reformation of the circuit or the formation of a bridge circuit to provide partial functional return through a more indirect route. Presently, little is known about the specificity of how regenerating axons reconnect or reconstruct functional circuits. We have established an in vivo Dorsal root entry zone (DREZ) model, which in the presence of Nerve Growth Factor (NGF), shows very robust regeneration of peptidergic nociceptive axons, but not other sensory axons...
July 11, 2014: Neuroscience
Yucel Kanpolat, Eyyub Al-Beyati, Hasan Caglar Ugur, Gokhan Akpinar, Gokmen Kahilogullari, Melih Bozkurt
Complex Regional Pain Syndrome Type I (CRPS-I) is a debated health problem concerning its pathophysiology and treatment strategies. A 12-year-old boy and a 35-year-old woman were diagnosed with CRPS-I at different times. They had previously undergone various types of interventions with no success. After one year of follow-up and observation, DREZ lesioning operation was performed. Afterwards, both cases had transient lower extremity ataxia. The first case was followed for 60 months with no recurrence and total cure...
2014: Turkish Neurosurgery
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