Evaluation of Mesencephalotomy and Thalamotomy and Their Comparison with Other Surgical Methods

Abstract

Many circumstances participate in the decision which method and which surgical technique is to-day selected by the neurosurgeon for controlling intractable pain from the upper half of the body and for central pain. His experience with some of the operations available and his predilections are decisive, as is the technical equipment and scope of his centre. It should surprise nobody that with these operations which we have in mind and which bear on such delicate structures as the spinomedullary junction, or the brain stem, much depends on the skill of the neurosurgeon, regarding the smooth course and good result; whereas one centre gets acquainted and elaborates, in due course, a certain type of operation, becoming fond of it and propagating its use as a rewarding operation, other centres may express fundamental objections and reservations against the selfsame method, or completely refuse its use. The diversity of view on the various operations as well as on approach routes and surgical tactics may be easily understood from the foregoing.