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Keywords = dorsal root entry zone (DREZ)

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41 pages, 7627 KiB  
Review
Neurosurgical Treatment of Pain
by Rafael G. Sola and Paloma Pulido
Brain Sci. 2022, 12(11), 1584; https://doi.org/10.3390/brainsci12111584 - 20 Nov 2022
Cited by 8 | Viewed by 4691
Abstract
The aim of this review is to draw attention to neurosurgical approaches for treating chronic and opioid-resistant pain. In a first chapter, an up-to-date overview of the main pathophysiological mechanisms of pain has been carried out, with special emphasis on the details in [...] Read more.
The aim of this review is to draw attention to neurosurgical approaches for treating chronic and opioid-resistant pain. In a first chapter, an up-to-date overview of the main pathophysiological mechanisms of pain has been carried out, with special emphasis on the details in which the surgical treatment is based. In a second part, the principal indications and results of different surgical approaches are reviewed. Cordotomy, Myelotomy, DREZ lesions, Trigeminal Nucleotomy, Mesencephalotomy, and Cingulotomy are revisited. Ablative procedures have a limited role in the management of chronic non-cancer pain, but they continues to help patients with refractory cancer-related pain. Another ablation lesion has been named and excluded, due to lack of current relevance. Peripheral Nerve, Spine Cord, and the principal possibilities of Deep Brain and Motor Cortex Stimulation are also revisited. Regarding electrical neuromodulation, patient selection remains a challenge. Full article
(This article belongs to the Section Sensory and Motor Neuroscience)
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