Microscissor DREZotomy for post-brachial plexus avulsion neuralgia is an advanced neurosurgical procedure pioneered by Dr. Ramesh Doddamani at AIIMS, New Delhi, designed to manage severe, drug-resistant neuropathic pain following brachial plexus injuries. Brachial plexus avulsion can result in intractable pain due to hyperactive neurons in the dorsal horn of the spinal cord, leading to a debilitating condition that is often refractory to medications or conventional pain management strategies.

This technique involves precise dissection of the dorsal root entry zone (DREZ) using microsurgical scissors under high magnification. By selectively interrupting hyperactive pain-transmitting fibers while sparing surrounding neural structures, microscissor DREZotomy effectively reduces spontaneous and evoked neuropathic pain. The procedure focuses on maximizing pain relief while minimizing motor or sensory deficits, which is critical in maintaining limb function and quality of life in affected patients.

Clinical experience from a single-center study demonstrates that patients undergoing this procedure experience significant long-term pain reduction, improved functional outcomes, and enhanced daily living activities. The minimally invasive and targeted nature of the technique also reduces intraoperative trauma, blood loss, and postoperative complications compared to older, less precise DREZ lesioning methods.