When conservative management of central pain in spinal cord injury (SCI) has failed to provide adequate relief, ablative surgery may be beneficial in carefully selected cases. Cordotomy and other procedures have been advocated in the past but are no longer in widespread use due to concerns about efficacy and morbidity. The standard dorsal root entry zone (DREZ) procedure is currently the primary focus of neurosurgical management of central pain, but its effectiveness is limited to at-level pain. Recently, the advent of neurophysiologically directed lesioning has been shown to improve the success rate of the DREZ technique and has expanded the indications to include below-level central pain.

central pain, deafferentation pain, DREZ, neurogenic pain, pain surgery, paraplegia, spinal cord injury
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