Survey of the value of neurosurgical treatment for the relief of intractable pain

Scott, Michael; Wycis, H. T.

doi:10.1016/0002-9610(49)90140-3

Cited by 6 publications

References 35 publications

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Lateral Spinothalamic Tractotomy for Relief of Pain in Cauda Equina Injury

Saussure¹

1950

Arch NeurPsych

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Martin1 in 1912, has been of immeasurable benefit to patients with intractable pain below the level of the fourth or fifth dermatome. The operation has found its greatest usefulness in patients with pain caused by malignant growths.2 More recently, because of the growing incidence of traumatic paraplegia, it has been suggested as a method of relieving the pain that accompanies spinal cord injuries. These lesions were common during the war as a result of gunshot and shrapnel wounds and are now seen in increasing frequency because of injury following traffic and mining or other occupational accidents.Lateral spinothalamic tractotomy has proved successful in relieving the discomfort of patients with pain following injuries to the cauda equina. This type of injury frequently causes intractable pain.Almost without exception, injury to the caudal roots results in intractable pain, sufficiently severe to arrest all efforts at rehabilitation, which must be the ultimate goal in the treatment of paraplegia. It is the purpose of this paper to present a series of 11 cases of trauma to the cauda equina with resultant partial or complete paraplegia in which relief of pain was obtained by bilateral spinothalamic tractotomy. Cauda equina pain is excruciating, sharp, and radiates along the distribution of the nerve roots. It is persistent but varies in intensity.

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