Thalamotomy for Control of Chronic Pain

  • D. E. Richardson
Conference paper
Part of the Acta Neurochirurgica book series (NEUROCHIRURGICA, volume 21)


For the past several years I have attempted to develop a stereotaxic procedure at the level of the thalamus for control of chronic pain. A stereotaxic operation has several theoretical advantages over older procedures such as rhizotomy, tractotomy, and prefrontal lobotomy for pain. Firstly, procedures at this level would control pain over the entire contralateral half of the body and would not be limited to anatomical segments, which would be helpful in difficult areas of pain control such as craniocervical pain. Secondly, stereotaxic procedures can be performed easily under local anesthesia, obviating the use of general anesthesia and prolonged open operations on patients who are often debilitated with advanced cancer. Thirdly, on theoretical grounds, at the level of the thalamus sensation should be segregated into its different components of touch, proprioception, temperature, and pain; allowing preferential destruction of pain in the conducting system without the associated loss of sensation of other types. Fourth, anatomical separation from the motor and other systems reduce the complications of weakness, ataxia, and incontinence, that are not uncommonly seen after tractotomy in the spinal cord or brain stem. Lastly, it should not have the destructive effect on personality associated with prefrontal lobotomy.


Chronic Pain Centre Median Reticular Formation Somatosensory Input Spinothalamic Tract 
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Copyright information

© Springer-Verlag 1974

Authors and Affiliations

  • D. E. Richardson
    • 1
    • 2
  1. 1.Division of Neurological Surgery, Department of SurgeryTulane University School of MedicineNew OrleansUSA
  2. 2.New OrleansUSA

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