Spinal Cord Injury Transitional Zone Pain

The treatment of spinal cord injury pain is one of the most challenging clinical problems in pain neurosurgery. It represents a type of deafferentation pain that resists most treatment modalities. And while ablative neurosurgical procedures have largely been abandoned in the treatment of deafferentation pain, it still plays an important role in transitional zone pain. This chapter outlines the essential clinical features of transitional zone pain following spinal cord injury and describes the use of dorsal root entry zone lesioning (DREZ) in its management. The decision-making process involved in offering this procedure is nuanced, and this chapter provides key considerations important in counseling patients prior to surgery.