Original article
Treatment of neuropathic deafferentation pain using DREZ lesions; long-term results
Tratamiento del dolor neuropático por desaferentización mediante lesión DREZ, resultados a largo plazo
F. Ruiz-Juretschke
, F. García-Salazar†, R. García-Leal, C. Fernández-Carballal, B. Iza, J.M. Garbizu, S. García-Duque, T. Panadero
Corresponding author
Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Carnero-Pardo, C. Sáez-Zea, L. Montiel-Navarro, I. Feria-Vilar, M. Gurpegui" "autores" => array:5 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Carnero-Pardo" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Sáez-Zea" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Montiel-Navarro" ] 3 => array:2 [ "nombre" => "I." "apellidos" => "Feria-Vilar" ] 4 => array:2 [ "nombre" => "M." 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"apellidos" => "Ruiz-Juretschke" "email" => array:1 [ 0 => "doc.fer@gmx.de" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "F." "apellidos" => "García-Salazar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">†</span>" "identificador" => "fn1" ] ] ] 2 => array:2 [ "nombre" => "R." "apellidos" => "García-Leal" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Fernández-Carballal" ] 4 => array:2 [ "nombre" => "B." "apellidos" => "Iza" ] 5 => array:2 [ "nombre" => "J.M." "apellidos" => "Garbizu" ] 6 => array:2 [ "nombre" => "S." "apellidos" => "García-Duque" ] 7 => array:2 [ "nombre" => "T." "apellidos" => "Panadero" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento del dolor neuropático por desaferentización mediante lesión DREZ, resultados a largo plazo" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-02-25" "fechaAceptado" => "2010-09-23" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec157319" "palabras" => array:5 [ 0 => "Brachial plexus avulsion" 1 => "Deafferentation" 2 => "Dorsal root entry zone" 3 => "Pain" 4 => "Spinal injury" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec157318" "palabras" => array:5 [ 0 => "Avulsión plexo braquial" 1 => "Desaferentización" 2 => "Dorsal root entry zone" 3 => "Dolor" 4 => "Lesión medular" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Deafferentation pain secondary to spinal cord injury, brachial plexus avulsion and other peripheral nerve injuries is often refractory to conventional treatments. This study evaluates the long-term efficacy of spinal DREZ (Dorsal Root Entry Zone) lesions for the treatment of neuropathic pain syndromes caused by deafferentation.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A series of 18 patients with refractory deafferentation pain treated with radiofrequency DREZ lesions is presented. The immediate and long-term efficacy was measured with the Visual Analogue Scale (VAS) before and after treatment, the patient's subjective evaluation, the percentage of patients returning to work and the reduction in pain medication.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Pain on the VAS significantly decreased from 8.6 preoperatively to 2.9 (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001) at release. Over the long-term, with a mean follow-up of 28 months (6–108) pain remained at 4.7 on the VAS (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.002). The percentage of patients with moderate to excellent pain relief was 77% at discharge and 68% at the last follow-up. Pain medication was reduced in 67% of the patients and 28% returned to work. The best results were obtained in patients with brachial plexus avulsion, with a significant long-term pain relief in all cases.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Radiofrequency DREZ lesion is an effective and safe treatment for refractory neuropathic pain caused by deafferentation.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El dolor por desaferentización secundario a lesiones medulares, avulsión del plexo braquial y otras lesiones de nervios periféricos, es a menudo refractario a tratamientos convencionales. Este trabajo evalúa la eficacia a largo plazo de la cirugía de lesión DREZ (Dorsal Root Entry Zone) en diversos síndromes de dolor neuropático por desaferentización.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se presenta una serie de 18 pacientes con dolor refractario por desaferentización tratados mediante lesión DREZ con radiofrecuencia. La eficacia inmediata y a largo plazo se valoró mediante la escala visual analógica (EVA) preoperatoria y postoperatoria, la valoración subjetiva del paciente, la reincorporación laboral y la reducción de la medicación analgésica.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El dolor en la EVA disminuyó significativamente de 8,6 antes de la cirugía a 2,9 de media al alta (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,001). A largo plazo, con un seguimiento medio de 28 meses (6–108), el dolor se mantuvo en 4,7 en la EVA (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,002). El porcentaje de pacientes con un alivio moderado a excelente del dolor fue de 77% al alta y 68% a largo plazo. El 67% de los pacientes redujo la medicación analgésica y el 28% se reincorporó al trabajo. Los mejores resultados se obtuvieron en los pacientes con avulsión del plexo braquial con una mejoría significativa del dolor a largo plazo en todos los casos.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La lesión DREZ por radiofrecuencia es un tratamiento eficaz y seguro para el dolor neuropático refractario por desaferentización.</p>" ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "†" "nota" => "<p class="elsevierStyleNotepara">Dr. Francisco García Salazar, the driving force behind pain surgery at our department and the lead surgeon in all the cases presented in this series, died on October 5th, 2009, during the preparation of this manuscript. R.I.P.</p>" ] 1 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">No work similar to this manuscript has been published or submitted to another journal for publication. Some of the data included in this work were reported at the 14th Annual Conference of the Spanish Neurology Society (SENEC) held in Seville in May 2009.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fiber organization at the posterior spinal cord-rootlet junction in man" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Sindou" 1 => "C. Quoex" 2 => "C. Baleydier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cne.901530103" "Revista" => array:6 [ "tituloSerie" => "J Comp Neurol" "fecha" => "1974" "volumen" => "153" "paginaInicial" => "15" "paginaFinal" => "26" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4817344" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Selective surgery of posterior nerve roots. First results of surgery for pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Sindou" 1 => "G. Fischer" 2 => "A. Goutelle" 3 => "L. Mansuy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurochirurgie" "fecha" => "1974" "volumen" => "20" "paginaInicial" => "391" "paginaFinal" => "408" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4468379" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dorsal root entry zone lesions for pain relief" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B.S. Nashold Jr" 1 => "R.H. Ostdahl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1979.51.1.0059" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1979" "volumen" => "51" "paginaInicial" => "59" "paginaFinal" => "69" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/448420" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The tract of Lissauer in relation to sensory transmission in the dorsal horn of spinal cord in the macaque monkey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Denny-Brown" 1 => "E.J. Kirk" 2 => "N. Yanagisawa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cne.901510206" "Revista" => array:6 [ "tituloSerie" => "J Comp Neurol" "fecha" => "1973" "volumen" => "151" "paginaInicial" => "175" "paginaFinal" => "200" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4355326" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of refractory pain after brachial plexus avulsion with dorsal root entry zone lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Samii" 1 => "S. Bear-Henney" 2 => "W. Ludemann" 3 => "M. Tatagiba" 4 => "U. Blomer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "2001" "volumen" => "48" "paginaInicial" => "1269" "paginaFinal" => "1275" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11383729" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A new type of microelectrode for obtaining unitary recordings in the human spinal cord" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Guenot" 1 => "J.M. Hupe" 2 => "P. Mertens" 3 => "A. Ainsworth" 4 => "J. Bullier" 5 => "M. Sindou" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1999" "volumen" => "91" "numero" => "Suppl" "paginaInicial" => "S25" "paginaFinal" => "S32" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic deafferentation of human spinal cord neurons" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.D. Loeser" 1 => "A.A. Ward Jr" 2 => "L.E. White Jr" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1968.29.1.0048" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1968" "volumen" => "29" "paginaInicial" => "48" "paginaFinal" => "50" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5244625" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of dorsal root entry zone lesion on spinal cord potentials evoked by segmental, ascending and descending volleys" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H. Fujioka" 1 => "K. Shimoji" 2 => "M. Tomita" 3 => "S. Denda" 4 => "T. Hokari" 5 => "M. Tohyama" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1992" "volumen" => "117" "paginaInicial" => "135" "paginaFinal" => "142" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dorsal root entry zone lesions for the treatment of brachial plexus avulsion injuries: a follow-up study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.H. Friedman" 1 => "B.S. Nashold Jr" 2 => "P.R. Bronec" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1988" "volumen" => "22" "paginaInicial" => "369" "paginaFinal" => "373" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3352888" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term follow up of dorsal root entry zone lesions in brachial plexus avulsion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.G. Thomas" 1 => "N.D. Kitchen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Neurol Neurosurg Psychiatry" "fecha" => "1994" "volumen" => "57" "paginaInicial" => "737" "paginaFinal" => "738" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8006657" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcomes of brachial plexus reconstruction in 204 patients with devastating paralysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.K. Terzis" 1 => "M.D. Vekris" 2 => "P.N. Soucacos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Plast Reconstr Surg" "fecha" => "1999" "volumen" => "104" "paginaInicial" => "1221" "paginaFinal" => "1240" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10513901" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrasonic DREZ-operations for treatment of pain due to brachial plexus avulsion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "O.N. Dreval" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1993" "volumen" => "122" "paginaInicial" => "76" "paginaFinal" => "81" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal and nucleus caudalis dorsal root entry zone operations for chronic pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y. Kanpolat" 1 => "H. Tuna" 2 => "M. Bozkurt" 3 => "A.H. Elhan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "2008" "volumen" => "62" "numero" => "Suppl 1" "paginaInicial" => "S235" "paginaFinal" => "S242" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Microcoagulation of junctional dorsal root entry zone is effective treatment of brachial plexus avulsion pain: longterm follow-up study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B. Prestor" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Croat Med J" "fecha" => "2006" "volumen" => "47" "paginaInicial" => "271" "paginaFinal" => "278" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16625692" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Results of DREZ coagulations for pain related to plexus lesions, spinal cord injuries and postherpetic neuralgia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.A. Rath" 1 => "V. Braun" 2 => "N. Soliman" 3 => "G. Antoniadis" 4 => "H.P. Richter" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1996" "volumen" => "138" "paginaInicial" => "364" "paginaFinal" => "369" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dorsal root entry zone coagulation for treatment of deafferentation pain syndromes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "X.H. Zhang" 1 => "Y.J. Li" 2 => "Y.S. Hu" 3 => "W. Tao" 4 => "Z. Zheng" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Chin Med J (Engl)" "fecha" => "2008" "volumen" => "121" "paginaInicial" => "1089" "paginaFinal" => "1092" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long term follow-up results of dorsal root entry zone lesions for intractable pain after brachial plexus avulsion injuries" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.J. Chen" 1 => "Y.K. Tu" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir" "fecha" => "2006" "volumen" => "99" "paginaInicial" => "S73" "paginaFinal" => "S75" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dorsal root entry zone lesioning used to treat central neuropathic pain in patients with traumatic spinal cord injury: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.R. Denkers" 1 => "H.L. Biagi" 2 => "M. Ann O’Brien" 3 => "A.R. Jadad" 4 => "M.E. Gauld" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Spine (Phila Pa 1976)" "fecha" => "2002" "volumen" => "27" "paginaInicial" => "E177" "paginaFinal" => "E184" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pain and spinal cysts in paraplegia: treatment by drainage and DREZ operation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B.S. Nashold Jr" 1 => "J. Vieira" 2 => "A.O. el-Naggar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Neurosurg" "fecha" => "1990" "volumen" => "4" "paginaInicial" => "327" "paginaFinal" => "335" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2222879" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Thermocoagulation of the dorsal root entry zone for the treatment of intractable pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Samii" 1 => "J.R. Moringlane" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1984" "volumen" => "15" "paginaInicial" => "953" "paginaFinal" => "955" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6514171" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Microsurgical lesioning in the dorsal root entry zone for pain due to brachial plexus avulsion: a prospective series of 55 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.P. Sindou" 1 => "E. Blondet" 2 => "E. Emery" 3 => "P. Mertens" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.2005.102.6.1018" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "2005" "volumen" => "102" "paginaInicial" => "1018" "paginaFinal" => "1028" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16028760" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dorsal root entry zone lesions for intractable pain after trauma to the conus medullaris and cauda equina" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.H. Sampson" 1 => "R.E. Cashman" 2 => "B.S. Nashold Jr" 3 => "A.H. Friedman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1995.82.1.0028" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1995" "volumen" => "82" "paginaInicial" => "28" "paginaFinal" => "34" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7815130" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "DREZ surgery on conus medullaris (after failed implantation of vascular omental graft) for treating chronic pain due to spine (gunshot) injuries" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Spaic" 1 => "S. Petkovic" 2 => "R. Tadic" 3 => "L. Minic" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1999" "volumen" => "141" "paginaInicial" => "1309" "paginaFinal" => "1312" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Microsurgical DREZotomy (MDT) for pain, spasticity, and hyperactive bladder: a 20-year experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Sindou" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1995" "volumen" => "137" "paginaInicial" => "1" "paginaFinal" => "5" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Microsurgical junctional DREZ coagulation for treatment of deafferentation pain syndromes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B. Prestor" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Surg Neurol" "fecha" => "2001" "volumen" => "56" "paginaInicial" => "259" "paginaFinal" => "265" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11738680" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dorsal root entry zone lesions for post-amputation pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.C. Saris" 1 => "R.P. Iacono" 2 => "B.S. Nashold Jr" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1985.62.1.0072" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1985" "volumen" => "62" "paginaInicial" => "72" "paginaFinal" => "76" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3964856" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Laser-induced dorsal root entry zone lesions for pain control. Report of three cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "W.J. Levy" 1 => "A. Nutkiewicz" 2 => "Q.M. Ditmore" 3 => "C. Watts" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1983.59.5.0884" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1983" "volumen" => "59" "paginaInicial" => "884" "paginaFinal" => "886" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6194280" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dorsal root entry zone microcoagulation for spinal cord injury-related central pain: operative intramedullary electrophysiological guidance and clinical outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Falci" 1 => "L. Best" 2 => "R. Bayles" 3 => "D. Lammertse" 4 => "C. Starnes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "2002" "volumen" => "2" "numero" => "Suppl" "paginaInicial" => "S193" "paginaFinal" => "S200" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735808/0000002600000001/v1_201305151237/S2173580811700050/v1_201305151237/en/main.assets" "Apartado" => array:4 [ "identificador" => "9407" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735808/0000002600000001/v1_201305151237/S2173580811700050/v1_201305151237/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580811700050?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 9 | 12 | 21 |
| 2024 September | 23 | 16 | 39 |
| 2024 August | 16 | 25 | 41 |
| 2024 July | 8 | 13 | 21 |
| 2024 June | 10 | 23 | 33 |
| 2024 May | 12 | 11 | 23 |
| 2024 April | 11 | 17 | 28 |
| 2024 March | 18 | 26 | 44 |
| 2024 February | 14 | 24 | 38 |
| 2024 January | 12 | 12 | 24 |
| 2023 December | 9 | 17 | 26 |
| 2023 November | 7 | 24 | 31 |
| 2023 October | 58 | 12 | 70 |
| 2023 September | 28 | 11 | 39 |
| 2023 August | 22 | 18 | 40 |
| 2023 July | 51 | 48 | 99 |
| 2023 June | 38 | 15 | 53 |
| 2023 May | 41 | 12 | 53 |
| 2023 April | 24 | 8 | 32 |
| 2023 March | 16 | 10 | 26 |
| 2023 February | 8 | 11 | 19 |
| 2023 January | 10 | 20 | 30 |
| 2022 December | 7 | 12 | 19 |
| 2022 November | 18 | 16 | 34 |
| 2022 October | 9 | 19 | 28 |
| 2022 September | 10 | 22 | 32 |
| 2022 August | 9 | 14 | 23 |
| 2022 July | 10 | 14 | 24 |
| 2022 June | 8 | 10 | 18 |
| 2022 May | 6 | 8 | 14 |
| 2022 April | 11 | 10 | 21 |
| 2022 March | 7 | 27 | 34 |
| 2022 February | 6 | 11 | 17 |
| 2022 January | 10 | 7 | 17 |
| 2021 December | 6 | 13 | 19 |
| 2021 November | 4 | 11 | 15 |
| 2021 October | 11 | 23 | 34 |
| 2021 September | 4 | 18 | 22 |
| 2021 August | 6 | 7 | 13 |
| 2021 July | 6 | 14 | 20 |
| 2021 June | 9 | 3 | 12 |
| 2021 May | 7 | 12 | 19 |
| 2021 April | 14 | 5 | 19 |
| 2021 March | 10 | 10 | 20 |
| 2021 February | 9 | 8 | 17 |
| 2021 January | 13 | 8 | 21 |
| 2020 December | 4 | 5 | 9 |
| 2020 November | 5 | 13 | 18 |
| 2020 October | 3 | 8 | 11 |
| 2020 September | 7 | 9 | 16 |
| 2020 August | 9 | 6 | 15 |
| 2020 July | 5 | 1 | 6 |
| 2020 June | 4 | 2 | 6 |
| 2020 May | 2 | 13 | 15 |
| 2020 April | 8 | 9 | 17 |
| 2020 March | 10 | 4 | 14 |
| 2020 February | 7 | 6 | 13 |
| 2020 January | 4 | 9 | 13 |
| 2019 December | 14 | 10 | 24 |
| 2019 November | 4 | 9 | 13 |
| 2019 October | 3 | 10 | 13 |
| 2019 September | 5 | 3 | 8 |
| 2019 August | 0 | 4 | 4 |
| 2019 July | 6 | 18 | 24 |
| 2019 June | 14 | 30 | 44 |
| 2019 May | 13 | 53 | 66 |
| 2019 April | 2 | 21 | 23 |
| 2019 March | 3 | 7 | 10 |
| 2019 February | 1 | 8 | 9 |
| 2018 December | 2 | 7 | 9 |
| 2018 November | 0 | 1 | 1 |
| 2018 October | 8 | 10 | 18 |
| 2018 September | 3 | 10 | 13 |
| 2018 August | 4 | 4 | 8 |
| 2018 July | 3 | 0 | 3 |
| 2018 June | 0 | 3 | 3 |
| 2018 May | 2 | 4 | 6 |
| 2018 April | 0 | 10 | 10 |
| 2018 March | 1 | 2 | 3 |
| 2018 February | 2 | 0 | 2 |
| 2018 January | 1 | 3 | 4 |
| 2017 December | 4 | 1 | 5 |
| 2017 November | 4 | 4 | 8 |
| 2017 October | 1 | 7 | 8 |
| 2017 September | 2 | 7 | 9 |
| 2017 August | 4 | 22 | 26 |
| 2017 July | 9 | 3 | 12 |
| 2017 June | 11 | 11 | 22 |
| 2017 May | 15 | 1 | 16 |
| 2017 April | 9 | 1 | 10 |
| 2017 March | 8 | 31 | 39 |
| 2017 February | 11 | 2 | 13 |
| 2017 January | 11 | 3 | 14 |
| 2016 December | 11 | 0 | 11 |
| 2016 November | 7 | 0 | 7 |
| 2016 October | 12 | 1 | 13 |
| 2016 September | 9 | 1 | 10 |
| 2016 August | 6 | 0 | 6 |
| 2016 July | 4 | 0 | 4 |
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