Dorsal root entry zone lesions (Nashold's procedure) for pain relief following brachial plexus avulsion

Abstract

Brachial plexus avulsion is an important cause of severe intractable pain, particularly in young motor cyclists. The pain usually develops soon after the injury. In a minority of cases severe pain persists and is refractory to management. Nineteen patients are reviewed in whom dorsal root entry zone lesions have been produced for pain relief. The operative technique is described. Early post-operative motor or sensory disturbance in the ipsilateral leg have been temporary side effects, with mild persisting deficits in a minority. Sixteen cases have had significant persisting pain relief. The maximum follow-up period is 2 1/2 years.