Posterior Spinal Rhizotomy: A Substitute for Cordotomy in the Relief of Localized Pain in Patients with Normal Life-Expectancy

White, James; Kjellberg, Raymond N.

doi:10.1055/s-0028-1090507

Cited by 14 publications

(7 citation statements)

References 6 publications

(10 reference statements)

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“…In 1968, Echols [3] reported good results after spinal rhizotomy in 60% of cases of persistent pain after disc surgery. The same rate of success was found by White [9] in 1973, in 62 patients. In 1974, Uematsu [7] report ed the use of percutaneous spinal rhizotomy for pain and Lazortlies [5] obtained good results using this technique in 20 patients.…”

Section: Introductionsupporting

confidence: 83%

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Percutaneous Radiofrequency Spinal Rhizotomy

Pagura¹

1983

Stereotact Funct Neurosurg

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An anatomical study was conducted to evaluate the emergence of spinal roots at different levels and their relation to the intervertebral foramena. A percutaneous needie was thernnserted in the direction of these roots and their contact studied under direct vision and by X-rays. These results were compared with those obtained in 50 patients who underwent spinal rhizotomies. There is a direct correlation between the anatomy at different levels and the quality of relief obtained after surgery.

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Section: Introductionsupporting

confidence: 83%

“…This permits a better evaluation of both pain and hypoesthesia and limits the lesion to the needs of the patient. This is perhaps the reason for the lack of postoperative dysesthesias mentioned by Wepsic [9]. Also, the constant motor examination prevents us from inducing significant weakness.…”

Section: Discussionmentioning

confidence: 98%

Percutaneous Radiofrequency Spinal Rhizotomy

Pagura¹

1983

Stereotact Funct Neurosurg

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“…White and Kjellberg [35] reported that dysesthesia was a serious complication after rhizotomy in no less than 4 of 21 individuals, and described the nature of dysesthesia as a disagreeable burning sensation, made worse by rubbing the skin, or spontaneous bursts of radicular pain just below the level of analgesia. Pagni [36] also stated that if only limited skin sensory loss followed dorsal rhizotomy, patients would not be distressed by paresthesia or painful anesthesia; however, these problems did occur in a certain percentage of cases in which multiple root section gave rise to marked sensory loss.…”

Section: Discussionmentioning

confidence: 99%

Dorsal Rhizotomy for Pain from Neoplastic Lumbosacral Plexopathy in Advanced Pelvic Cancer

Son

Yoon²,

Kim

et al. 2014

Stereotact Funct Neurosurg

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Background: Pain from neoplastic lumbosacral plexopathy is resistant to conventional pain treatment. According to a recent review of destructive procedures for cancer pain, only cordotomy has been reported to play an important role in the treatment of cancer pain. To date, the effectiveness of dorsal rhizotomy, which selectively interrupts pain transmission, has not been shown in neoplastic lumbosacral plexopathy. Objectives: The present study seeks to find out the effectiveness of selective dorsal rhizotomies for intractable pain from neoplastic lumbosacral plexopathy in terminal pelvic cancer patients. Methods: Dorsal rhizotomies of the involved segments were performed on 6 cancer patients in whom neuropathic pain from lumbosacral plexus involvement in terminal pelvic cancer had been refractory to other therapies. Clinical efficacy of the procedure was assessed by comparing patient pain ratings and narcotic usage before and after dorsal rhizotomy. Results: Examination of the results indicated a significant reduction in pain ratings as well as a significant reduction in daily narcotic use. No adverse neurological effects were observed and no recurrence of pain from neoplastic lumbosacral plexopathy was noted. Conclusions: These findings provide corroborating clinical evidence for the effectiveness of selective dorsal root rhizotomy for the intractable pain from lumbosacral plexopathy in terminal pelvic cancer patients.

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“…It has been reported as a side effect of sensory rhizotomies used to treat localized pain syndromes [16]. This is the same type of unpleasant sensation that occurs in spinal cord injury, expanding syringes and after surgery for intramedullary spinal cord tumors.…”

Section: Postoperative Discomfortmentioning

confidence: 96%

Complications with Selective Posterior Rhizotomy

Abbott

1992

Pediatr Neurosurg

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Since 1986 250 patients have undergone selective posterior rhizotomy for spastic cerebral palsy at New York University Medical Center. Severe, perioperative complications were experienced by 15 % of these patients and consisted of bronchospasm, aspiration pneumonia, urinary retention, ileus, sensory loss. Additionally, most of our patients had severe pain immediately after the surgery and nearly half had dysesthesias for up to 3 weeks. Long-term complications such as decreasing range of muscle movement and hip dislocation are now becoming apparent. This patient population must be viewed as having special risks attendant with surgery and particularly with selective posterior rhizotomy.

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Posterior Spinal Rhizotomy: A Substitute for Cordotomy in the Relief of Localized Pain in Patients with Normal Life-Expectancy

Cited by 14 publications

References 6 publications

Percutaneous Radiofrequency Spinal Rhizotomy

Percutaneous Radiofrequency Spinal Rhizotomy

Dorsal Rhizotomy for Pain from Neoplastic Lumbosacral Plexopathy in Advanced Pelvic Cancer

Complications with Selective Posterior Rhizotomy

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