First time in Vietnam: Cutting spinal pain transmission pathways helps cancer patients experience significant pain relief
A 69-year-old female patient in Ho Chi Minh City, diagnosed with stage III breast cancer, has just undergone successful surgery using the DREZtomy technique – a neurointerventional procedure on the spinal cord aimed at eliminating chronic pain signals. This is the first such surgery in Vietnam performed by the team of doctors from the Department of Peripheral Neurology, University Medical Center, Ho Chi Minh City.
Refractory pain: Challenges in caring for cancer patients
The patient was diagnosed with left breast cancer stage III, had a lumpectomy and postoperative radiotherapy. However, nearly 1 year later, she began experiencing severe neuropathic pain episodes in the left shoulder, neck, and arm, accompanied by muscle weakness, insomnia, poor appetite, and dependence on pain medication.
This is a typical manifestation of chronic radiation-induced brachial plexus pain (Chronic Radiation-Induced Brachial Plexopathy - CRIBP). It is a rare but severe complication, usually appearing late from a few months to several decades after cancer treatment. Women after breast cancer treatment are the highest risk group.
Although many medical treatment methods and psychological support have been applied, patients still experience continuous pain, severely affecting quality of life.
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Prof. Dr. Lê Viết Thắng and Associate Prof. Dr. Bùi Hoàng Tuấn Dũng - Department of Neurology, University Medical Center Ho Chi Minh City are examining patients (Photo: BVCC)
DREZtomy - advanced technique cutting pain transmission pathways from the spinal cord
Given that situation, the multidisciplinary experts at the hospital decided to choose DREZtomy - a technique that intervenes in the posterior horn of the spinal cord to disrupt the pain signal pathway, usually applied when all other methods are no longer effective.
According to the surgeon, the biggest challenge is accurately identifying the lesion location in the spinal cord to ensure cutting the correct pain transmission pathway without harming motor or sensory function. The team used 3 Tesla MRI technology, intraoperative neurophysiological monitoring (IONM), and combined surgical microscope to achieve maximum precision.
Even though this is the first time being performed in Vietnam, the surgery was successful. After the operation, the patient experienced a marked reduction in pain giảm đau rõ rệt - from a level of 8/10 down to 3/10 on the VAS scale, with significant improvements in sleep, mobility, mood, and reduced medication dependence.
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Pain-relief interventions through nerve surgery bring new hope for patients with chronic pain after radiation therapy
The success of this first DREZtomy case marks a new breakthrough in the field of peripheral neurology and palliative care for cancer patients in Vietnam. In the context of increasingly longer survival rates among cancer patients, refractory chronic pain has become a major barrier to quality of life. Techniques such as DREZtomy will be an important tool to improve this issue.
The representative of the Department of Neurology shares: "Our goal is not only to extend life, but also to help patients live better in their own journey fighting cancer".