Dorsal Root Entry Zone Lesioning

Pain is usually managed with non-surgical methods such as oral medications, injections and nerve blocks. When these options fail and severe pain turns into a chronic condition, Dorsal Root Entry Zone (DREZ) lesioning may be the next step for you. DREZ lesioning can help significantly relieve pain in up to 70 percent of select patients who undergo the procedure.

What is a DREZ lesion?

DREZ lesioning is a neurosurgical procedure in which a very focused lesion (tissue change) is made in the spine where the nerves emerge out of the back of the spinal cord. While this procedure involves creating a lesion in the spine, when done appropriately with adequate monitoring, it can be done safely and effectively. The procedure does not require any implants, long-term maintenance, programming or battery replacements. Moreover, it is very effective for certain diagnoses for which spinal cord stimulation has not been effective, such as brachial plexus injury.

Am I a candidate for DREZ lesioning for pain management?

If medications and other therapies fail to treat your pain symptoms, your doctor considers surgical options. You may also be a candidate for DREZ lesioning if you experience:

• Brachial plexus injury pain
• Cancer pain in your arm or leg due

What happens during DREZ lesioning surgery?

In preparation for surgery, your doctor will order a specialized MRI to evaluate your cervical spine anatomy. It will be used to pinpoint the precise area of your spine to target.
During the procedure, you are placed under general anesthesia. The spinal cord is inspected to identify where the nerves emerge or where the nerves have detached from the spinal cord (due to prior injury). A very focused lesion is created in this region. Spinal cord function is monitored throughout the procedure to reduce the risk of numbness or weakness after the surgery.

What to expect after DREZ lesioning

The surgery relieves symptoms, but it is not a cure. In carefully selected patients, up to 70 percent experience immediate pain relief and long-term relief for at least one year. Patients should expect to be hospitalized for about five days after surgery. Postoperative pain from the procedure can be severe, but subsides relatively rapidly.

Interested in DREZ lesioning at UCLA? Get prepared for your first appointment.