Medial thalamotomy using stereotactic radiosurgery for intractable pain: a systematic review

Franzini, Andrea; Rossini, Zefferino; Moosa, Shayan; Tropeano, Maria Pia; Milani, Davide; Attuati, Luca; Clerici, Elena; Navarria, Pierina; Pessina, Federico; Picozzi, Piero

doi:10.1007/s10143-021-01561-x

Cited by 15 publications

(13 citation statements)

References 26 publications

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“…This leaves patient with few remaining options for adequate pain control. In a review of patients who underwent SRS medial thalamotomies, 42% of whom had cancer-related pain, the majority of patient had meaningful pain reduction; and more posteriorly placed lesions were associated with better outcomes ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, due to numerous neurological and sensory complications that arose from surgeries at the pontine and mesencephalic level, stereotactic thalamotomies became the surgery of choice (5,6). Early thalamotomies primarily targeted the lateral thalamus due to its role in relaying the sensory-discriminative aspect of pain; however, these interventions often resulted in high rates of somatosensory deficits (6)(7)(8). Medial thalamic targets had the benefit of lower rates of somatosensory deficits by instead retarding the affective-emotional aspect of chronic pain (7,(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

“…Early thalamotomies primarily targeted the lateral thalamus due to its role in relaying the sensory-discriminative aspect of pain; however, these interventions often resulted in high rates of somatosensory deficits (6)(7)(8). Medial thalamic targets had the benefit of lower rates of somatosensory deficits by instead retarding the affective-emotional aspect of chronic pain (7,(9)(10)(11). In recent years, there has been a resurgence in the use of ablative surgery (9,(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

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Neuroablative central lateral thalamotomy for chronic neuropathic pain

et al. 2022

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Chronic neuropathic pain refractory to medical management can be debilitating and can seriously affect one's quality of life. The interest of ablative surgery for the treatment or palliation of chronic neuropathic pain, cancer-related or chemotherapy-induced, has grown. Numerous regions along the nociceptive pathways have been prominent targets including the various nuclei of the thalamus. Traditional targets include the medial pulvinar, central median, and posterior complex thalamic nuclei. However, there has been little research regarding the role of the central lateral nucleus. In this paper, we aim to summarize the anatomy, pathophysiology, and patient experiences of the central lateral thalamotomy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Neuroablative central lateral thalamotomy for chronic neuropathic pain

et al. 2022

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Section: Discussionmentioning

confidence: 99%

“…The use of thalamotomy for managing chronic pain conditions has been used before [ 38 , 39 , 40 ]. Franzini and colleagues studied medial thalamotomy using stereotactic radiosurgery for the treatment of intractable pain [ 40 ]. They showed that medial thalamotomy using stereotactic radiosurgery is a relatively effective and safe method [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Management of Phantom Limb Pain through Thalamotomy of the Centro-Median Nucleus

Torre¹,

Hernández²,

Al-Ramadan³

et al. 2021

Neurology International

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Background: Phantom limb syndrome is defined as the perception of intense pain or other sensations that are secondary to a neural lesion in a limb that does not exist. It can be treated using pharmacological and surgical interventions. Most medications are prescribed to improve patients’ lives; however, the response rate is low. In this case report, we present a case of phantom limb syndrome in a 42-year-old female with a history of transradial amputation of the left thoracic limb due to an accidental compression one year before. The patient underwent placement of a deep brain stimulator at the ventral posteromedial nucleus (VPM) on the right side and removal secondary to loss of battery. The patient continued to have a burning pain throughout the limb with a sensation of still having the limb, which was subsequently diagnosed as phantom limb syndrome. After a thorough discussion with the patient, a right stereotactic centro-median thalamotomy was offered. An immediate response was reported with a reduction in pain severity on the visual analogue scale (VAS) from a value of 9–10 preoperative to a value of 2 postoperative, with no postoperative complications. Although phantom limb pain is one of the most difficult to treat conditions, centro-median thalamotomy may provide an effective stereotactic treatment procedure with adequate outcomes.

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