Microvascular Decompression Surgery in India

DREZ (Dorsal Root Entry Zone) operation is a type of surgery for the nerve pain (caused by nerves being torn away from the spinal cord), sometimes by the spinal cord injuries. It is performed when the conservative treatments (non-operative) are unable to provide any relief to the patients. The surgeon enters the spinal cord to treat the damaged area where damaged nerves join the central nervous system. It helps to intercept the pain messages that nerves send to the brain.

What is post traumatic trigeminal neuropathy?

The trigeminal nerve is one of the largest sensory nerves in the human body and represents the majority of the sensory cortex. Trigeminal neuropathy pain is a condition that affects the trigeminal nerve. The neuropathic pain following tissue or nerve injury in the trigeminal nerve distribution may be known as painful post traumatic trigeminal neuropathy. In trigeminal neuralgia, even mild stimulation of your face – such as brushing your teeth or applying makeup, may trigger severe pain. Post-traumatic trigeminal neuropathy is the continuous pain that occurs due to complete and partial damage to the peripheral nerve or the nervous system. The pain you feel is a continuous and burning numbness.

Symptoms of post-traumatic trigeminal neuropathy

  • You may experience severe or sharp pain that may feel like an electric shock.
  • Pain triggered with the mild stimulation on your face, such as touching your face, chewing, speaking, brushing your teeth, etc.
  • Pain sessions may last from few seconds to several minutes.
  • Incidents of pain attacks lasting for days or more, some of the people have situations where they don’t experience any pain.
  • Continuous pain, burning sensation may occur before it develops into trigeminal neuralgia.
  • The trigeminal nerve supplies the pain in the areas including cheek, jaw, teeth, gums, lips and less frequent to the eye or forehead.
  • The pain is usually felt at the one side of the face, in some of the rare cases it affects both sides of the face.
  • Pain is focused on one spot or spreads in a wider pattern.
  • The frequency and severity of pain attacks increase with time.

Types of posttraumatic trigeminal neuralgia

The posttraumatic trigeminal neuralgia is further classified into two types typical (TN1) and atypical (TN2).

  • Typical (TN1)- The Typical (classic) form of posttraumatic trigeminal neuralgia is causes extreme, sudden burning and shock-like pain in the face area where nerve branches are distributed, such as cheek, jaw, teeth, gums, lips, scalp and forehead. The pain sessions last from few seconds to several minutes or longer.
  • Atypical (TN2)- Atypical form of posttraumatic trigeminal neuralgia is defined by constant aching, burning and stabbing pain which has a lower intensity than the typical form (TN1). There is not a specific trigger point for the pain, however, it gets worse with the time.

Treatment

The treatment of post traumatic trigeminal neuropathy usually starts with the medications. However, there are situations when medications are not effective anymore, then surgeries and injections are considered as treatment options.

  • Medication -There are drugs such as Carbamazepine, Baclofen, Pheytoin, Oxcarbazepine, etc are used to control the pain. However, there are side effects of the drugs too which include, drowsiness, confusion, depression, dizziness, balance disturbance, etc.
  • Surgery

    • Microvascular decompression– The blood vessels are removed or relocated are in contact with the trigeminal root to stop the nerve from malfunctioning. The surgeon makes an incision behind your ear on the pain side. A surgeon uses a small hole to move your arteries that are in contact with the trigeminal nerve and makes a space between the nerve and the arteries by using a small cushion. If a vein is compressing the nerve, then your surgeon may remove it. Microvascular decompression helps to reduce the pain most of the time.
    • DREZ operation– DREZ (Dorsal Root Entry Zone) operation is a type of surgery for the nerve pain (caused by nerves being torn away from the spinal cord), sometimes by the spinal cord injuries. It is performed when the conservative treatments (non-operative) are unable to provide any relief to the patients. The surgeon enters the spinal cord to treat the damaged area where damaged nerves join the central nervous system. It helps to intercept the pain messages that nerves send to the brain.
    • Brain stereotactic radiosurgery (Gamma knife)- Brain stereotactic radiosurgery is performed by the surgeon to damage the trigeminal nerve. The surgeon uses a gamma knife to damage the trigeminal nerve without making an incision on the skull. This procedure reduces pain.
    • Rhizotomy-Rhizotomy is a process which destroys the nerve fibers to reduce the pain, this procedure causes some numbness in the face. It includes
      • Glycerol Injection- The doctor injects the small amount of sterile glycerol and it damages the trigeminal nerves and intercepts the pain signals to the brain.
      • Balloon compression-The doctor inserts a hollow needle through your face and guides it to the trigeminal nerve. Then the doctor places a catheter (thin flexible tube) with a balloon at the end through the needle. A balloon is inflated with such pressure that it damages the trigeminal nerves and stop the pain signals.
      • Radiofrequency thermal lesioning- A hollow needle through your face and guide it to the trigeminal nerve, then your surgeon inserts an electrode through the needle and sends a mild electrical current. The surgeon asks you to indicate when and where you feel tingling.

Cost of DREZ (Dorsal Root Entry Zone) operation

The cost of posttraumatic neuralgic pain treatment depends on the type of procedure. However, you can contact us to know the charges of DREZ and other treatments by contacting us.

Dr. (Prof.) Sumit Sinha is one of the best neurosurgeons in Delhi (India). He has vast experience of over 17 years in the field of Neurosurgery. He is also one of the most awarded brain surgeons/ doctors in Delhi. Your search for the best doctor of the brain in India ends here. Please contact us.

Lecturing on Minimally invasive spinal surgery at recently concluded meeting by Artemis hospitals Gurugram.