There are few conditions the physician has to treat which cause so much distress as that of intense pain uncontrolled by drugs. A means of relief in selected cases is afforded by chordotomy. The operation will not be entirely successful in every case in which it is employed—some pain fibers occasionally will escape the knife—but the operation has now been performed sufficiently often to justify a belief in its efficacy. It is a delicate procedure, requires a skilful technic, and is not to be undertaken lightly by one untrained in the surgery of the spinal cord. It requires on the part of the operator a visualization of the microscopic anatomy of the cord, and a realization that a slight misplacement of the incision may cause motor paralysis of one or both lower limbs, depending on whether the division is unilateral or bilateral. We1 have written on this subject
FRAZIER CH, SPILLER WG. SECTION OF THE ANTEROLATERAL COLUMNS OF THE SPINAL CORD (CHORDOTOMY): DISCUSSION OF THE PHYSIOLOGIC EFFECTS AND CLINICAL RESULTS IN A SERIES OF EIGHT CASES. Arch NeurPsych. 1923;9(1):1–21. doi:10.1001/archneurpsyc.1923.02190190004001
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