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Hopkins Medicine Magazine - Burning Away Intractable Pain

Hopkins Medicine Spring/Summer 2013

Burning Away Intractable Pain

Date: June 7, 2013

When neurosurgeon Allan Belzberg met Marc Burleson, it was clear that the 31-year-old Marine had suffered through an incredible ordeal. While Burleson was defusing a buried bomb in Afghanistan in December 2011, it exploded, leaving him unconscious for nearly a month. When he woke up, he was blind in one eye and missing half of his right arm. His left arm was paralyzed.

But the most horrific part of his injuries was a searing, unrelenting pain in his paralyzed left arm. Despite heavy doses of narcotics delivered by a doctors at Walter Reed Army Medical Center, the pain—which Burleson described alternately as a hot torch being rolled up and down against his arm or his bones being extracted through his fingertips—jolted him a couple of times a minute, every minute of the day and night.

The pain emanated from scars in his spinal cord, resulting from nerves being ripped out from the force of the blast, Belzberg explains. “It’s like an electrical cord being pulled out of a socket,” he says. The scars left in the socket cause a syndrome in the spinal cord much like epilepsy in the brain. But instead of having seizures, Burleson experienced flashes of incredible pain.

“Life wasn’t going to go on for him without help,” Belzberg says.

Help was something that the Hopkins surgeon was able to offer. A few times a year, he performs a rare operation for injuries similar to Burleson’s, in which limbs are often violently jerked away from the body. To stop the resulting scars in the spinal cord from firing pain messages, Belzberg and his colleagues open the patient’s spine to access the cord. Once there, they use a surgical microscope to accurately pinpoint the scar tissue, then use a radiofrequency probe to burn it away.

In July 2012, Belzberg and his colleagues operated on Burleson, making 140 precise burns in his spinal cord. When he awoke, Burleson almost immediately noticed that he no longer had pain. “He was so happy, that he said he wanted to marry me,” Belzberg recalls. CB

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