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Spinal Cord Injury, Central Deafferent, Neuropathic Pain and Neurosurgery

Craig Hospital does not have a formal pain management program for patients with low back pain or other sources of pain that are not spinal cord injury related. We also do not admit inpatients or outpatients with a primary diagnosis of pain, or need for primary pain management services. However, central deafferent or neurogenic pain can occur following spinal cord injury. These are pains generated by the injured spinal cord itself. Following spinal cord injury, patients can experience pain in areas of the body where they do not have normal sensation. These pains can occur anywhere at or below the level of injury. Patients classically describe these pains as burning, stinging, stabbing, electrical, sharp, shooting and/or squeezing, tight, pressure, and vise-like. These pains may present at or very near the time of the injury or may occur later (one to many years after the time of injury). The first line of treatment for these kinds of pains is medication. Typically antidepressants or antiseizure medications are used to treat these pains. If medication is not successful, neurosurgical intervention may be appropriate.

Neurosurgical Interventions for Pain

  • Computer-Assisted Dorsal Root Entry Zone Microcoagulation (CA- DREZ): This surgery is performed on the paraplegic population for burning, sharp, electrical, stabbing, pins-and-needles, and "aching" pains which occur at or below the level of injury. It involves electrical recording inside the spinal cord at the time of surgery to identify regions of abnormally active pain-producing nerve cells. These abnormal nerve cells are then destroyed with radio frequency heat lesions.
  • Spinal Cord Untethering and/or Cyst or Syrinx Shunting: In some patients, the presence of "tethering" or scarring of the spinal cord, or the presence of a cyst or syrinx within the spinal cord causes abnormal activity of pain-producing nerve cells within the spinal cord. Surgical release of the scar tissue (spinal cord untethering) alone or in addition to drainage of the cyst (cyst shunting) may lead to pain relief.Please refer to the tethered spinal cord section for more information. 

Contact Dr. Scott Falci

If you would like to make a referral to Dr. Falci, want further information, or have questions, please call Charlotte Indeck, RN at Dr. Falci’s office at 303-761-5281 or e-mail cindeck@craighospital.org. Because of the high volume of requests and our busy surgery schedule, please allow several days to hear back. If your request requires a quicker response, please indicate that when you call. If you are having a medical emergency, call 911.