ABSTRACT
The dorsal root entry zone (DREZ) operation was originally developed by Dr. Blaine S. Nashold, Jr. based on laboratory and clinical observations concerning deafferentation pain. The initial clinical indications were intractable, persistent pain resulting from plexus avulsion, for example, brachial plexus and lumbosacral plexus avulsions resulting from trauma. The first operations for DREZ lesioning were performed by Dr. Nashold on patients at Duke University Medical Center beginning in 1976 and provided substantial relief for patients with intractable pain secondary to plexus avulsions. Although Marc Sindou of Lyons had described and performed ‘‘selective posterior rhizotomy’’ as early as 1972, the DREZ operation was unique in that it was designed to interrupt completely the sensory pathways by destroying the second order neurons in the dorsal horn rather than preferen-
tially destroy only the small-diameter nociceptive fibers as in Sindou’s rhizotomy.
