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June 17, 1933

ANTEROLATERAL CHORDOTOMY FOR INTRACTABLE PAIN

Author Affiliations

ANN ARBOR, MICH.
From the Department of Surgery, University Hospital.

JAMA. 1933;100(24):1925-1928. doi:10.1001/jama.1933.02740240021007
Abstract

Although Spiller's operation of anterolateral chordotomy has been often performed since 1911 for the control of intractable pain, it may still be said to be a much neglected procedure, the great scope of which has not been recognized by the medical profession.

Historically, Van Gehuchten in 1893 first expressed the definite opinion that fibers conveying pain and temperature sensation passed up the cord in Gowers' tract, although Gowers himself had suggested this in 1879.

No actual proof was afforded until Spiller's1 fortunate observation of a patient at the Philadelphia General Hospital in August, 1904. This patient showed an almost complete loss of the sense of pain and temperature in the legs, with preservation of tactile sensibility. He was under observation for some months and died in January, 1905. The necropsy revealed a solitary tubercle involving the right tract of Gowers at the extreme lower end of the thoracic cord

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