Stereotactic Trigeminal Tractotomy

Schvarcz, J. R.

doi:10.1159/000102714

Cited by 32 publications

(20 citation statements)

References 4 publications

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“…Schvarcz 6,7 then transformed the procedure into a percutaneous approach by using a special stereotactic apparatus designed for craniocervical junction lesioning such as tractotomy and myelotomy. Lesioning of the tract and nucleus, which is universally ablated because of its proximity to the tract, is essential for treating cancerassociated pain of the face and neuropathic facial pain syndromes or anesthesia dolorosa.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous trigeminal tractotomy–nucleotomy with use of intraoperative computed tomography and general anesthesia: report of 2 cases

Thompson

Burchiel²,

Raslan³

2013

FOC

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For confirming the correct location of the radiofrequency electrode before creation of a lesion, percutaneous CT-guided trigeminal tractotomy–nucleotomy is most commonly performed with the patient prone and awake. However, for patients whose facial pain and hypersensitivity are so severe that the patients are unable to rest their face on a support (as required with prone positioning), awake CT-guided tractotomy-nucleotomy might not be feasible. The authors describe 2 such patients, for whom percutaneous intraoperative CT-guided tractotomy-nucleotomy under general anesthesia was successful. One patient was a 79-year-old man with profound left facial postherpetic neuralgia, who was unable to tolerate awake CT-guided tractotomy-nucleotomy, and the other was a 45-year-old woman with intractable hemicranial pain that developed after a right frontal lesionectomy for epilepsy. Each patient underwent a percutaneous intraoperative CT-guided tractotomy-nucleotomy under general anesthesia. No complications occurred, and each patient reported excellent pain relief for up to 6 and 3 months after surgery, respectively. Percutaneous intraoperative CT-guided tractotomy-nucleotomy performed on anesthetized patients is effective for facial postherpetic neuralgia and postoperative hemicranial neuralgia.

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Section: Discussionmentioning

confidence: 99%

Percutaneous trigeminal tractotomy–nucleotomy with use of intraoperative computed tomography and general anesthesia: report of 2 cases

Thompson

Burchiel²,

Raslan³

2013

FOC

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show abstract

“…I have used this stereotactic technique since 1971, emphasizing the importance of lesioning the oral pole of sub nucleus caudalis in some cases of facial pain of central origin [36,37,39].…”

Section: Stereotactic Trigeminal Nucleotomymentioning

confidence: 99%

“…The results of this deeper nuclear lesion [36,37,39] are then in contrast to those of open medullary tractotomy, which has consistently failed to relieve these central pain states [21 ].…”

Section: Stereotactic Trigeminal Nucleotomymentioning

confidence: 99%

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Spinal Cord Stereotactic Techniques re Trigeminal Nucleotomy and Extralemniscal Myelotomy

Schvarcz¹

1978

Stereotact Funct Neurosurg

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The application of stereotactic techniques to the spinal cord as a logical sequel to percutaneous procedures have produced significant developments by enabling the functional exploration of different cord structures. Radiofrequency lesions were placed either at the spinal trigeminal nucleus, for facial pain of central origin such as postherpetic neuralgia or anesthesia dolorosa as well as for neoplastic pain of extensive craniofacial distribution, or at the central cord region to interrupt preferentially multisynaptic nonspecific pathways mainly for midline and/or bilateral pain but also for patients with respiratory inadequacy or for certain central pain states. Technical aspects are reported, and physiological correlates relevant to surgery are analyzed. Results, indications and limitations are discussed.

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“…More recently, Fox (1972) has introduced a percutaneous approach. I have used the technique described here since 1971 (Schvarcz 1972), emphasizing the importance of lesioning the oral pole of subnucleus caudalis in certain cases of facial central pain (Schvarcz 1974(Schvarcz , 1975(Schvarcz , 1977.…”

mentioning

confidence: 99%

Postherpetic craniofacial dysaesthesiae: Their management by stereotaxic trigeminal nucleotomy

Schvarcz

1977

Acta neurochir

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Stereotactic Trigeminal Tractotomy

Cited by 32 publications

References 4 publications

Percutaneous trigeminal tractotomy–nucleotomy with use of intraoperative computed tomography and general anesthesia: report of 2 cases

Percutaneous trigeminal tractotomy–nucleotomy with use of intraoperative computed tomography and general anesthesia: report of 2 cases

Spinal Cord Stereotactic Techniques re Trigeminal Nucleotomy and Extralemniscal Myelotomy

Postherpetic craniofacial dysaesthesiae: Their management by stereotaxic trigeminal nucleotomy

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