Anatomical and surgical basis of the dorsal root entry zone

Abstract

Introduction: The spinal Cord zone, known as “Dorsal Root Entry zone” (drez), is organized into a segmental separation of afferent myelinized fibers carrying the deep conscious sensibility at each rootless level, before its entrance into the Spinal Cord´s Dorsal Root, remaining the thinner A delta fibers, responsable of the mantainance of the pathological circuits for Pain and Spasticity, far more lateral into drez.
Materials: For the setting up of this monographic work an extensive bibliographic research about the subject was done on PUBMED and Mediline, looking for references of the period from 1970 until present, using the key words written on the heading paragraph.
Discusion: Based in the Melzack and Wall´s theory, segmentary or extensive lesions are done, tailored into the topographic lesional characteristics on each patient, on specific and refractory cases of chronic pain and spasticity.
Conclusions: The anatomical split of the sensitive ways into two separated bunches of fibers at the level of DREZ can be drawn upon to perform specific lesions on individualized thinner fibers, with the specific objective to treat pain and spasticity.