{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T20:44:04Z","timestamp":1767991444248,"version":"3.49.0"},"reference-count":10,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Surgery in the dorsal root entry zone (DREZ) was introduced in 1972 to treat pain and spasticity. Originally, Sindou\u2019s technique involved performing the DREZ surgical lesion utilizing a scalpel and bipolar cautery. Here, we introduce a variation of the original technique, avoiding cautery for 14 consecutive patients (Group 2), and compared them with a previous series of 22 patients, operated on with the original Sindou\u2019s technique (Group 1).<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We performed the modified DREZ technique in 14 consecutive patients with lower limb spasticity. After sharply opening the lateral sulcus (i.e., lateral to the dorsal root), we interspersed fragments of absorbable gelatin sponge to prevent heat from cautery spreading to the surrounding neural tissues.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n In the 1\n st<\/jats:sup>\n group, two of the 22 patients developed worsening unilateral paresis postoperatively. In the 2\n nd<\/jats:sup>\n group, after \u201ccold MDT,\u201d no patients, 0 of 14 total patients, were worse. Further, spasticity improved in approximately 82% of patients from both groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n In this short series of 14 patients (Group 2), we observed benefits similar to those described for patients undergoing classical DREZ lesions utilizing Sindou\u2019s technique (Group 1), but none sustained any new postoperative motor deficits.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_1035_2025","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T15:12:59Z","timestamp":1767971579000},"page":"9","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A modified (\u201ccold\u201d) technique of Sindou\u2019s dorsal root entry zone-otomy for spasticity of the lower limbs"],"prefix":"10.25259","volume":"17","author":[{"given":"Sergio Antonio","family":"Sacchettoni","sequence":"first","affiliation":[{"name":"Department of Neuro-Diagnostics, Neurology Mobile System Associates, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexis Javier","family":"Acevedo","sequence":"additional","affiliation":[{"name":"Department of Service of Neurosurgery, Hospital Vargas of Caracas, Caracas, Venezuela"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce Elizabeth","family":"Bola\u00f1os","sequence":"additional","affiliation":[{"name":"Department of Service of Physiatry and Rehabilitation, Neuro-QX, Centro M\u00e9dico Integra, Caracas, Venezuela,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joacir","family":"Graciolli Cordeiro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Miami, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernardo","family":"Assumpcao De Monaco","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Camden Clark Medical Center, West Virginia University, Parkersburg, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Physiatry and Pain Clinic, Neurology Mobile System Associates, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genesis Andreina","family":"Belandria-Moizant","sequence":"additional","affiliation":[{"name":"Department of Service of Neurosurgery, Hospital Vargas of Caracas, Caracas, Venezuela"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika Erzebet","family":"Ambrus","sequence":"additional","affiliation":[{"name":"Department of Neurology, Larkin Teaching Hospital, Miami, Florida, United States,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lliliam","family":"Cordero","sequence":"additional","affiliation":[{"name":"Department of Neuro-Diagnostics, Neurology Mobile System Associates, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Whu","sequence":"additional","affiliation":[{"name":"Department of Neuro-Diagnostics, Neurology Mobile System Associates, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas Enrique","family":"Merino Peraza","sequence":"additional","affiliation":[{"name":"Department of Physiology, Vargas School of Medicine, Universidad Central de Venezuela, Caracas, Venezuela"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"10.25259\/SNI_1035_2025\/ref-1","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1016\/j.clinph.2020.02.007","article-title":"Muscle responses to radicular stimulation during lumbo-sacral dorsal rhizotomy for spastic diplegia: Insights to myotome innervation","volume":"131","author":"Georgoulis","year":"2020","journal-title":"Clin Neurophysiol"},{"key":"10.25259\/SNI_1035_2025\/ref-2","first-page":"325","article-title":"Microsurgical drezotomy for spastic limbs","volume":"49","author":"Mertens","year":"2003","journal-title":"Neurochirurgie"},{"key":"10.25259\/SNI_1035_2025\/ref-3","first-page":"209","article-title":"Microsurgical drezotomy for the treatment of spasticity of the lower limbs","volume":"44","author":"Mertens","year":"1998","journal-title":"Neurochirurgie"},{"key":"10.25259\/SNI_1035_2025\/ref-4","first-page":"97","article-title":"Microsurgical selective procedures in peripheral nerves and the posterior root-spinal cord junction for spasticity","volume":"48","author":"Sindou","year":"1985","journal-title":"Appl Neurophysiol"},{"key":"10.25259\/SNI_1035_2025\/ref-5","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-030-92717-2_9","article-title":"Surgery in the dorsal root entry zone","volume-title":"Neurosurgery of spasticity","author":"Sindou","year":"2022"},{"key":"10.25259\/SNI_1035_2025\/ref-6","article-title":"Etude de la jonction radiculo-m\u00e9dullaire posterieure: La radicellotomie post\u00e9rieure selective dans la chirurgie de la douleur","author":"Sindou","year":"1972"},{"key":"10.25259\/SNI_1035_2025\/ref-7","first-page":"201","article-title":"The selective posterior radicellotomy for the treatment of spasticity (La radicellotomie post\u00e9rieure selective dans le traitement de la spasticit\u00e9-article in French)","volume":"130","author":"Sindou","year":"1974","journal-title":"Rev Neurol (Paris)"},{"key":"10.25259\/SNI_1035_2025\/ref-8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/BF02188771","article-title":"Microsurgical DREZotomy (MDT) for pain, spasticity, and hyperactive bladder: A 20-year experience","volume":"137","author":"Sindou","year":"1995","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_1035_2025\/ref-9","first-page":"335","article-title":"Results of selective posterior rhizotomy in the treatment of painful and spastic paraplegia secondary to multiple sclerosis","volume":"45","author":"Sindou","year":"1982","journal-title":"Appl Neurophysiol"},{"key":"10.25259\/SNI_1035_2025\/ref-10","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1002\/cne.901530103","article-title":"Fiber organization at the posterior spinal cord-rootlet junction in man","volume":"153","author":"Sindou","year":"1974","journal-title":"J Comp Neurol"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/a-modified-cold-technique-of-sindous-dorsal-root-entry-zone-otomy-for-spasticity-of-the-lower-limbs\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/a-modified-cold-technique-of-sindous-dorsal-root-entry-zone-otomy-for-spasticity-of-the-lower-limbs\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T15:13:01Z","timestamp":1767971581000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/a-modified-cold-technique-of-sindous-dorsal-root-entry-zone-otomy-for-spasticity-of-the-lower-limbs\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,9]]},"references-count":10,"alternative-id":["10.25259\/SNI_1035_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_1035_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1,9]]},"article-number":"9"}}