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Cole A. Giller, PhD, MD

Arch Neurol. 2003;60:1537-1540.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

The referral of a patient to a neurosurgeon for pain relief was once considered bad news, because the choice of procedures was limited to the creation of lesions offering significant risk and only modest success. The good news is that much has changed. Advances in technology and an improved understanding of pain have added sophisticated options and have guided attention to more effective procedures. An awareness of these capabilities has expanded the surgical indications for pain relief so extensively that a recent definitive textbook¹ discusses more than 30 types of procedures used in more than 18 major categories of pain.

This review will discuss some of the major neurosurgical interventions used for pain. More comprehensive articles can be found in several excellent books and reviews.^1-4

ABLATIVE SURGERY

Many ablative procedures have been replaced by treatment with electrical stimulation or the precise delivery of medication. We discuss some . . . [Full Text of this Article]

Methods of Ablation

Cordotomy

Dorsal Root Entry Zone Lesions

Sympathectomy

Myelotomy

Mesencephalotomy

Cingulotomy

STIMULATION

Spinal Cord Stimulation

Motor Cortex Stimulation

Deep Brain Stimulation

DELIVERY OF INTRASPINAL MEDICATION

SELECTED PAIN SYNDROMES

Cancer Pain

Failed Back Syndrome

Spinal Cord Injury

Trigeminal Neuralgia

CONCLUSIONS

From the Department of Neurological Surgery, The University of Texas Southwestern Medical Center at Dallas.

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