A novel method for making dorsal horn lesions.

Area of Science:

• Neurosurgery
• Spinal Cord Surgery
• Pain Management

Background:

• Current dorsal root entry zone (DREZ) lesioning for intractable pain necessitates extensive laminectomy for spinal cord access.
• A minimally invasive approach is needed to access multiple spinal cord segments for DREZ lesioning.

Purpose of the Study:

• To test the hypothesis that a silastic rubber catheter can be inserted into the dorsal horn through a single laminectomy site.
• To assess if the catheter can be advanced along several spinal cord segments exclusively within the dorsal horn.

Main Methods:

• Cervical laminectomy was performed in four sheep.
• Standard cerebrospinal fluid drainage catheters were inserted into the DREZ and advanced caudally within the dorsal horn.
• Neurophysiological monitoring and post-mortem histological analysis of serial spinal cord slices were conducted.

Main Results:

• The catheter remained within the dorsal horn grey matter along its entire insertion length.
• Dorsal horn activity was completely ablated in three sheep and partially ablated in one sheep post-catheter passage.

Conclusions:

• The spinal cord's architecture facilitates predictable catheter navigation within the dorsal horn.
• Dorsal horn lesioning for intractable pain can be achieved without direct surgical access to all target spinal cord segments.