Interruption of the spinothalamic tracts is a neurosurgical procedure for the treatment of intractable pain (Fig. 33-1). Because the level of analgesia may fall gradually, this procedure is most effective for treating intractable pain associated with malignant diseases. Although methods have been developed to interrupt these pain pathways percutaneously, the open operation still has a place in the neurosurgical armamentarium. Open cordotomy may be preferred for patients with deformities or congenital malformations of the cervical spine for craniovertebral junction patients who are unable or unwilling to cooperate with the intraoperative physiological testing needed for the percutaneous procedure, and for patients in whom a previously attempted percutaneous procedure could not be completed.
KeywordsNeurosurgical Procedure Intractable Pain Percutaneous Procedure Anterior Spinal Artery Spinothalamic Tract
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