Pain Management for the Neurosurgeon: Part 2

In this double issue of Seminars in Neurosurgery, our discussion of the surgical management of pain focuses on procedures. Our investigations are devoted to the theoretical basis of the various procedures covered, patient selection, technical aspects of the procedures, and expected outcomes.

The first three articles focus on trigeminal neuralgia, with regard to percutaneous procedures, radiosurgery, and microvascular decompression.

The following three articles detail neurostimulation for neuropathic pain, including spinal cord stimulation, motor cortex stimulation, and deep brain stimulation.

The final three articles in this two-part series discuss ablative operative procedures that have stood the test of time, and continue to add significantly to the neurosurgical armamentarium. These include stereotactic ablative procedures for relief of both cancer pain and chronic nonmalignant pain; percutaneous cordotomy and midline myelotomy predominantly for cancer pain; and surgery in the dorsal root entry zone for deafferentation pain.

I am both grateful and humbled that so many neurosurgical luminaries have chosen to devote their efforts to these articles. The reader will truly be learning about these procedures from world experts, many of whom are pioneers in their respective areas. My hope is that the reader will enjoy reviewing this material as much as I have enjoyed organizing it for Seminars in Neurosurgery.