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Article
May 1942

MESENCEPHALIC TRACTOTOMYA METHOD FOR THE RELIEF OF UNILATERAL INTRACTABLE PAIN

Author Affiliations

CHICAGO
From the Division of Neurological Surgery, University of Chicago.

Arch Surg. 1942;44(5):953-962. doi:10.1001/archsurg.1942.01210230177013
Abstract

Although many neurosurgical procedures have been suggested for the treatment of intractable pain, chordotomy is still the most satisfactory method for the relief of pain in the lower extremities, the abdomen and the thorax. It is not safe when performed in the rostral cervical segments for intractable pain in the upper extremities, owing to the danger of respiratory failure. To avoid this complication posterior rhizotomy has been suggested, but this is undesirable since the upper extremity then becomes anesthetic and useless. This procedure is of more value for the relief of severe pain in the neck. For pain in the arm, the neck and the face, a combination of section of the fifth and ninth cranial nerves and posterior cervical rhizotomy becomes a formidable procedure, especially in a patient who is already debilitated. In such cases Dogliotti1 suggested section of the lemniscus lateralis in the rostral part of the

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