Supplementary Material for: DREZotomy in the Treatment of Cancer Pain: A Review

Background: Cancer-related pain is a common problem that may be intractable by medical and neuromodulatory treatment. The dorsal root entry zone (DREZ) is a hyperactive focus in neuropathic pain syndromes, and DREZotomy has been used in selective cases of neuropathic cancer pain. Objective: The aim of this study was to describe the technique of spinal DREZotomy in the treatment of cancer pain and review the relevant published literature. Methods: A PubMed database search for ‘DREZ’, ‘dorsal root entry zone’ and ‘cancer’, and a search of the references of these manuscripts, was undertaken. Results: 14 papers were identified and reviewed that described a total of 123 patients with cancer pain or radiation-induced pain who have been treated with DREZotomy. Though heterogeneous, these studies reported an overall favorable outcome in carefully selected patients with topographically limited pain syndromes. Conclusion: For patients with well-localized neuropathic cancer pain intractable to medical and first-line surgical management, DREZotomy is a viable treatment option. Further prospective studies are needed to evaluate the outcomes of this procedure.