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August 1920

SECTION OF THE ANTEROLATERAL COLUMNS OF THE SPINAL CORD FOR THE RELIEF OF PAINA REPORT OF SIX CASES

Arch NeurPsych. 1920;4(2):137-147. doi:10.1001/archneurpsyc.1920.02180200002001
Abstract

It is the surgeon's duty at times to perform operations conceded to be only palliative in effect, such as gastro-enterostomy for incurable gastric carcinoma, tracheotomy for a malignant lesion of the larynx, subtemporal decompression for inoperable tumors of the brain. When pain is a conspicuous feature, justification for operation is undeniable. I have, on more than one occasion, removed the gasserian ganglion for an inoperable tumor of the middle fossa. The suffering, attending lesions of the spine or spinal cord involving the posterior roots, is often beyond relief from opium or its derivatives and under such circumstances surgical measures may with propriety be considered. In 1912 Spiller proposed section of the anterolateral columns of the cord, when for one cause or another the patient is suffering from intractable pain. Since that time I have carried out this operation on six occasions; in four there was complete, and in two partial,

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