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Dorsal root entry zone lesioning (DREZL) or DREZotomy is a viable surgical option for refractory cases.\u00a0This study aimed to compare DREZL surgical outcomes between patients with SCI and those with CEI and to identify predictors of postoperative pain relief.\u00a0We retrospectively analyzed 12 patients (6 with SCI and 6 with CEI) with intractable neuropathic pain who underwent DREZL. The data collected were demographic characteristics, pain distribution, and outcomes assessed by numeric pain rating scores. Variables and percentages of pain improvement at 1 year and long-term were statistically compared between the SCI and CEI groups.\u00a0The demographic characteristics and percentage of patients who experienced pain improvement at 1 year postoperatively did not differ between the groups. Compared with the SCI group, the CEI group presented significantly better long-term pain reduction (p\u2009=\u20090.020) and favorable operative outcomes (p\u2009=\u20090.015). Patients with border zone pain had significantly better long-term pain relief and outcomes than did those with diffuse pain (p\u2009=\u20090.008 and p\u2009=\u20090.010, respectively). Recurrent pain after DREZL occurred in the SCI group but not in the CEI group.\u00a0DREZL provided superior pain relief in patients with CEI. The presence of border zone pain predicted favorable outcomes. CEI patients or SCI patients with border zone pain are good surgical candidates for DREZL, whereas SCI patients with below-injury diffuse pain are poor candidates.<\/jats:p>","DOI":"10.1007\/s10143-024-03136-y","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T20:48:45Z","timestamp":1735850925000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparative outcomes of microsurgical dorsal root entry zone lesioning (DREZotomy) for intractable neuropathic pain in spinal cord and cauda equina injuries"],"prefix":"10.1007","volume":"48","author":[{"given":"Bunpot","family":"Sitthinamsuwan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanawat","family":"Ounahachok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sawanee","family":"Pumseenil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3895-956X","authenticated-orcid":false,"given":"Sarun","family":"Nunta-aree","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"3136_CR1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1146\/annurev.neuro.051508.135531","volume":"32","author":"M Costigan","year":"2009","unstructured":"Costigan M, Scholz J, Woolf CJ (2009) Neuropathic pain: a maladaptive response of the nervous system to damage. 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