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November 1950

LATERAL SPINOTHALAMIC TRACTOTOMY FOR RELIEF OF PAIN IN CAUDA EQUINA INJURY

Author Affiliations

MEMPHIS, TENN.

From the Section of Neurological Surgery, Veterans Administration Medical Teaching Group, Kennedy Hospital.

AMA Arch NeurPsych. 1950;64(5):708-714. doi:10.1001/archneurpsyc.1950.02310290104011
Abstract

LATERAL spinothalamic tractotomy, introduced by Spiller and Martin1 in 1912, has been of immeasurable benefit to patients with intractable pain below the level of the fourth or fifth dermatome. The operation has found its greatest usefulness in patients with pain caused by malignant growths.2 More recently, because of the growing incidence of traumatic paraplegia, it has been suggested as a method of relieving the pain that accompanies spinal cord injuries. These lesions were common during the war as a result of gunshot and shrapnel wounds and are now seen in increasing frequency because of injury following traffic and mining or other occupational accidents.

Lateral spinothalamic tractotomy has proved successful in relieving the discomfort of patients with pain following injuries to the cauda equina. This type of injury frequently causes intractable pain.

Almost without exception, injury to the caudal roots results in intractable pain, sufficiently severe to arrest all

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