DREZ - Lissauer's Tractotomy

DREZ surgery or Lissauer's Tractotomy and Medullary Posterior Horn Lesion consists of the dorsal spinal cord lesion in the dorsal entry zone. It can be performed with scalpel blade, or most commonly used technique, radiofrequency lesions. It is indicated for treatment of refractory spasticity and in cases of neuropathic pain, especially myelopathic pain.
Patients with brachial plexus lesion with neuropathic pain in the upper limb may present complete relief after DREZ surgery or Lissauer's Tract Lesion and Medullary Posterior Horn (or DREZotomy). It can be performed in the cervical, thoracic or lumbar spine, uni or bilaterally. Dr. Bernardo de Monaco applies a combination of DREZotomy surgery and Selective Dorsal Rhizotomy is selected cases to optimize the treatment of spasticity. Dr. Monaco, as well, developed a new technique to perform DREZotomy using intraoperative ultrasound, improving results and diminishing complications. 

 

DREZ; DREZotomy; Lissauer Tractotomy; Tractotomia de Lissauer; Lesão da Zona de Entrada da Raiz Dorsal; DREZotomia
Manuscript made by Prof. Sindou during a case discussion with Dr. Bernardo de Monaco - a real class with the teacher during a breakfast in Jurerê - Santa Catarina (Brazil) - 2016

The following link contains pictures of surgeries and procedures that can impress the visitor. Caution is recommended!

Click here to see an intraoperative image

DREZ; Tractotomia de Lissauer; DREZotomy; DREZotomia; Lesão do Tracto de Lissauer; Tratotomia de Lissauer
Microscopic view of the surgical procedure - opening of the postero-lateral sulcus of the spinal cord - Dr. Bernardo de Monaco - 2016