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Marc Guenot, Jean-Michel Hupe, Patrick Mertens, Alan Ainsworth, Jean Bullier, and Marc Sindou

units and allowing spikes and artifacts to be easily sorted. 2) The duration of the surgery must not be increased by more than a few minutes. 3) A compromise must be reached, as far as tip length and impedance are concerned, between the probability of recording from several units and the size of the recorded spikes. 4) The whole system has to be sterile. This new type of microelectrode has been developed to obtain intraoperative recordings in the dorsal horn of patients who suffer from persistent pain syndromes (due to a brachial plexus avulsion or a peripheral

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Patrick Mertens, Chantal Ghaemmaghami, Lionel Bert, Armand Perret-Liaudet, Marc Guenot, Hussein Naous, Laurent Laganier, Roger Later, Marc Sindou, and Bernard Renaud

patient (Case 3) with disabling spasticity of the left upper limb. The probe is implanted at the level of the DREZ of the upper T-1 rootlet. Right: Photograph obtained in a patient (Case 4) with chronic neuropathic pain due to left brachial plexus avulsion. The left dorsolateral sulcus (DS) of the spinal cord has been identified by its slightly yellow appearance. The probe is implanted in an area with complete avulsion of the dorsal rootlets, corresponding to the T-1 metameric level. DC = dorsal column; DR = dorsal rootlet; LC = lateral column. After collection

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Marc P. Sindou, Eric Blondet, Evelyne Emery, and Patrick Mertens

T he majority of brachial plexus injuries are dramatic and occur as a consequence of motorcycle accidents, predominantly in young adult men. The various types of lesions and corresponding mechanisms, mainly stretchings, have been masterfully described in Sunderland's 66 and Seddon's 54 classic books. Brachial plexus injuries are followed by chronic pain in the deafferented area in 30 to 90% of patients according to the literature. 3, 5, 35, 41, 44, 45, 54, 66 In groups of patients with predominantly preganglionic lesions, that is, root avulsions, as many as

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Corentin Dauleac, Timothée Jacquesson, and Patrick Mertens

. Administrative/technical/material support: Mertens. Study supervision: Mertens. References 1 Aichaoui F , Mertens P , Sindou M : Dorsal root entry zone lesioning for pain after brachial plexus avulsion: results with special emphasis on differential effects on the paroxysmal versus the continuous components. A prospective study in a 29-patient consecutive series . Pain 152 : 1923 – 1930 , 2011 2 Barbagallo GMV , Maione M , Raudino G , Certo F : Thoracic intradural-extramedullary epidermoid tumor: the relevance for resection of classic subarachnoid space