Destructive procedures for the treatment of nonmalignant pain: a structured literature review

Restricted access


Nonmalignant pain has been treated in the past century with ablative, or more appropriately, destructive procedures. Although individual outcomes for these procedures have previously been described in the literature, to the authors' knowledge this is the first comprehensive and systematic review on this topic.


A US National Library of Medicine PubMed search was conducted for the following ablative procedures: cingulotomy, cordotomy, DREZ (also input as dorsal root entry zone), ganglionectomy, mesencephalotomy, myelotomy, neurotomy, rhizotomy, sympathectomy, thalamotomy, and tractotomy. Articles related to pain resulting from malignancy and those not in peer-reviewed journals were excluded. In reviewing pertinent articles, focus was placed on patient number, outcome, and follow-up.


A total of 146 articles was included in the review. The large majority of studies (131) constituted Class III evidence. Eleven Class I and 4 Class II studies were found, of which nearly all (13 of 15) evaluated radiofrequency rhizotomies for different pain origins, including lumbar facet syndrome, cervical facet pain, and Type I or typical trigeminal neuralgia. Overall, support for ablative procedures for nonmalignant pain is derived almost entirely from Class III evidence; despite a long history of use in neurosurgery, the evidence supporting destructive procedures for benign pain conditions remains limited.


Newly designed prospective standardized studies are required to define surgical indications and outcomes for these procedures, to provide more systematic review, and to advance the field.

Abbreviations used in this paper: BPA = brachial plexus avulsion; DREZ = dorsal root entry zone; LFS = lumbar facet syndrome; RCT = randomized controlled trial; SCI = spinal cord injury; TN = trigeminal neuralgia; VAS = visual analog scale.

Article Information

Address correspondence to: Kim J. Burchiel, M.D., Department of Neurological Surgery, Oregon Health & Science University, CH8N, 3303 Southwest Bond Avenue, Portland, Oregon 97239. email:

© AANS, except where prohibited by US copyright law.



  • View in gallery

    Histogram showing the number of publications by category as a function of the year published.



Abdelaziz OSCosgrove GRStereotactic cingulotomy for the treatment of chronic pain. Burchiel KJ: Surgical Management of Pain New YorkThieme Medical Publishers2002. 812820


Amano KKawamura HTanikawa TKawabatake HNotani MIseki H: Long-term follow-up study of rostral mesencephalic reticulotomy for pain relief—report of 34 cases. Appl Neurophysiol 49:1051111986


Amano KKitamura KSano KSedino H: Relief of intractable pain from neurosurgical point of view with reference to present limits and clinical indications—a review of 100 consecutive cases. Neurol Med Chir (Tokyo) 16:1411531976


Ballantine HTCosgrove GRGiriunsa IESurgical treatment of intractable physchiatric illness and chronic pain by stereotactic cingulotomy. Schmidek HHSweet WH: PhiladelphiaWB Saunders1995. 14231430


Ballantyne JCLaForge KS: Opioid dependence and addiction during opioid treatment of chronic pain. Pain 129:2352552007


Barlocher CBKrauss JKSeiler RW: Kryorhizotomy: an alternative technique for lumbar medial branch rhizotomy in lumbar facet syndrome. J Neurosurg 98:14202003


Barnsley L: Percutaneous radiofrequency neurotomy for chronic neck pain: outcomes in a series of consecutive patients. Pain Med 6:2822862005


Bederson JBWilson CB: Evaluation of microvascular decompression and partial sensory rhizotomy in 252 cases of trigeminal neuralgia. J Neurosurg 71:3593671989


Benson KHartz AJ: A comparison of observational studies and randomized, controlled trials. N Engl J Med 342:187818862000


Broager B: Commissural myelotomy. Surg Neurol 2:71741974


Broager BOlesen KPsychosurgery in sixty-three cases of open cingulectomy and fourteen cases of bifrontal prehypothalamic cryolesion. Hitchcock ELaitinen LVaernet K: Psychosurgery Springfield, IllCharles C Thomas1972. 253257


Brodal A: Central course of afferent fibers for pain in facial, glossopharyngeal and vagus nerves. Clinical observation. Arch Neurol Psychiatry 57:2923071947


Broggi GFerroli PFranzini AGalosi L: The role of surgery in the treatment of typical and atypical facial pain. Neurol Sci 26:2 SupplS95S1002005


Broggi GFranzini ALasio GGiorgi CServello D: Longterm results of percutaneous retrogasserian thermorhizotomy for “essential” trigeminal neuralgia: considerations in 1000 consecutive patients. Neurosurgery 26:7837871990


Burchiel K: Surgical Management of Pain New YorkThieme2002


Burchiel KJ: A new classification for facial pain. Neurosurgery 53:116411672003


Burchiel KJ: Percutaneous retrogasserian glycerol rhizolysis in the management of trigeminal neuralgia. J Neurosurg 69:3613661988


Campbell JNSolomon CTJames CS: The Hopkins experience with lesions of the dorsal horn (Nashold's operation) for pain from avulsion of the brachial plexus. Appl Neurophysiol 51:1701741988


Cepero RMiller RHBressler KL: Long-term results of sphenopalatine ganglioneurectomy for facial pain. Am J Otolaryngol 8:1711741987


Choi CRUmbach W: Combined stereotaxic surgery for relief of intractable pain. Neurochirurgia (Stuttg) 20:84871977


Coffey RJLozano AM: Neurostimulation for chronic noncancer pain: an evaluation of the clinical evidence and recommendations for future trial designs. J Neurosurg 105:1751892006


Concato JShah NHorwitz RI: Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Engl J Med 342:188718922000


Cowie RAHitchcock ER: The late results of antero-lateral cordotomy for pain relief. Acta Neurochir (Wien) 64:39501982


Crue BLCarregal EJAFelsoory A: Percutanous stereotactic radiofrequency trigeminal tractotomy with neurophysiological recording. Stereotact Funct. Neurosurg 34:3893971972


Diemath HEHeppner FWalker AE: Anterolateral chordotomy for relief of pain. Postgrad Med 29:4854951961


Dougherty PMLee JDimitrou TLenz FAMedial thalamotomy. Burchiel KJ: Surgical Management of Pain New YorkThieme Medical Publishers2002. 812820


Dreval ON: Ultrasonic DREZ-operations for treatment of pain due to brachial plexus avulsion. Acta Neurochir (Wien) 122:76811993


Dreyfuss PHalbrook BPauza KJoshi AMcLarty JBogduk N: Efficacy and validity of radiofrequency neurotomy for chronic lumbar zygapophysial joint pain. Spine 25:127012772000


Dubuisson D: Treatment of occipital neuralgia by partial posterior rhizotomy at C1-3. J Neurosurg 82:5815861995


Echols DH: Sensory rhizotomy following operation for ruptured intervertebral disc. A review of 62 cases. J Neurosurg 31:3353381969


Edgar REBest LGQuail PAObert AD: Computer-assisted DREZ microcoagulation: posttraumatic spinal deafferentation pain. J Spinal Disord 6:48561993


Eriksen JSjogren PBruera EEkholm ORasmussen NK: Critical issues on opioids in chronic non-cancer pain: an epidemiological study. Pain 125:1721792006


Faillace LAAllen RPMcQueen JDNorthrup B: Cognitive deficits from bilateral cingulotomy for intractable pain in man. Dis Nerv Syst 32:1711751971


Fedder SL: T2-ganglionectomy via limited costotransversectomy for minor causalgia. Spine 15:2692701990


Foltz ELWhite LE: The role of rostral cingulumotomy in “pain” relief. Int J Neurol 6:3533731968


Frank SKieburtz KHolloway RKim SYH: What is the risk of sham surgery in Parkinson disease clinical trials? A review of published reports. Neurology 65:110111032005


Frankel SAProkop JD: Value of cordotomy for the relief of pain. N Engl J Med 264:9719741961


Freed CRGreene PEBreeze RETsai WYDuMouchel WKao R: Transplantation of embryonic dopamine neurons for severe Parkinson's disease. N Engl J Med 344:7107192001


Freeman TBVawter DELeaverton PEGodbold JHHauser RAGoetz CG: Use of placebo surgery in controlled trials of a cellular-based therapy for Parkinson's disease. N Engl J Med 341:9889921999


French LA: High cervical tractotomy: technique and results. Clin Neurosurg 21:2392451974


Friedman AHBullitt E: Dorsal root entry zone lesions in the treatment of pain following brachial plexus avulsion, spinal cord injury and herpes zoster. Appl Neurophysiol 51:1641691988


Friedman AHNashold BS Jr: DREZ lesions for relief of pain related to spinal cord injury. J Neurosurg 65:4654691986


Gallagher JPetriccione di Vadi PLWedley JRHamann WRyan PChikanza I: Radiofrequency facet joint denervation in the treatment of low back pain: a prospective controlled double-blind study to assess its efficacy. Pain Clin 7:1931981994


Geurts JWMvan Wijk RMAWWynne HJHammink EBuskens ELousberg R: Radiofrequency lesioning of dorsal root ganglia for chronic lumbosacral radicular pain: a randomised, double-blind, controlled trial. Lancet 361:21262003


Govind JKing WBailey BBogduk N: Radiofrequency neurotomy for the treatment of third occipital headache. J Neurol Neurosurg Psychiatry 74:88932003


Grant FCWood FA: Experiences with cordotomy. Clin Neurosurg 5:38651957


Gybels JTasker RSupratentorial neurosurgery for the treatment of pain. McMahon SKoltzenberg M: Wall and Melzack's Textbook of Pain ed 5LondonElsevier2006. 553561


Helfant MHLeksell LStrang RR: Experiences with intractable pain treated by stereotaxic mesencephalotomy. Acta Chir Scand 129:5735801965


Hitchock ERSchvarcz JR: Stereotaxic trigeminal tractotomy for post-herpetic facial pain. J Neurosurg 37:4124171972


Hitchcock ERTeixeira MJ: A comparison of results from center-median and basal thalamotomies for pain. Surg Neurol 15:3413511981


Hooten WMMartin DPHuntoon MA: Radiofrequency neurotomy for low back pain: evidence-based procedural guidelines. Pain Med 6:1291382005


Hosobuchi Y: The majority of unmyelinated afferent axons in human ventral roots probably conduct pain. Pain 8:1671801980


Hosobuchi YRutkin B: Descending trigeminal tractotomy. Neurophysiological approach. Arch Neurol 25:1151251971


Hurt RWBallantine HT Jr: Stereotactic anterior cingulate lesions for persistent pain: a report on 68 cases. Clin Neurosurg 21:3343511974


Ishijima BShimoji KShimizu HTakahashi HSuzuki I: Lesions of spinal and trigeminal dorsal root entry zone for deafferentation pain. Experience of 35 cases. Appl Neurophysiol 51:1751871988


Jansen J: Surgical treatment of non-responsive cervicogenic headache. Clin Exp Rheumatol 18:S67S702000


Jeanmonod DMagnin MMorel AMedial thalamotomycommentary. Burchiel K: Surgical Management of Pain New YorkThieme Medical Publishers2002. 802804


Jeanmonod DMagnin MMorel A: Thalamus and neurogenic pain: physiological, anatomical and clinical data. Neuroreport 4:4754781993


Jirásek A: The Surgery of Pain PragueNew Horizons1962


Kanpolat Y: Percutaneous cordotomy, tractotomy, and midline myelotomy: minimally invasive stereotactic pain procedures. Semin Neurosurg 15:2032192004


Kanpolat YSavas AAkyar SCosman E: Percutaneous computed tomography-guided spinal destructive procedures for pain control. Neurosurg Q 14:2292382004


Kanpolat YSavas ABatay FSinav A: Computed tomography-guided trigeminal tractotomy-nucleotomy in the management of vagoglossopharyngeal and geniculate neuralgias. Neurosurgery 43:4844901998


Kanpolat YSavas ABekar ABerk C: Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1,600 patients. Neurosurgery 48:5245342001


Kato SOtsuki TYamamoto TIwasaki YYoshimoto T: Retrograde adriamycin sensory ganglionectomy: novel approach for the treatment of intractable pain. Stereotact Funct Neurosurg 54–55:86891990


Kudo TYoshii NShimizu SAikawa SNishioka SNakahama H: [Stereotaxic thalamotomy for pain relief.]. Seishin Igaku Kenkyusho Gyosekishu 15:15301968. (Jpn)


Kumagai YShimoji KHonma TUchiyama SIshijima BHokari T: Problems related to dorsal root entry zone lesions. Acta Neurochir (Wien) 115:71781992


Kunc Z: Treatment of essential neuralgia of the 9th nerve by selective tractotomy. J Neurosurg 23:4945001965


Laitinen LVilkki JStereotactic ventral anterior cingulotomy in some psychological disorders. Hitchcock ELaitinen LVaernet K: Psychosurgery SpringfieldCharles C Thomas1972. 242252


Le Beau J: Anterior cingulectomy in man. J Neurosurg 11:2682761954


Leclaire RFortin LLambert RBergeron YMRossignol M: Radiofrequency facet joint denervation in the treatment of low back pain: a placebo-controlled clinical trial to assess efficacy. Spine 26:141114172001


Lende RAKirsch WMDruckman R: Relief of facial pain after combined removal of precentral and postcentral cortex. J Neurosurg 34:5375431971


Levy WJNutkiewicz ADitmore QMWatts C: Laser-induced dorsal root entry zone lesions for pain control. Report of three cases. J Neurosurg 59:8848861983


Liberson WTVoris HCUematsu S: Recording of somatosensory evoked potentials during mesencephalotomy for intractable pain. Confin Neurol 32:1851941970


Loeser JD: Dorsal rhizotomy for the relief of chronic pain. J Neurosurg 36:7457501972


Lord SMBarnsley LWallis BJMcDonald GJBogduk N: Percutaneous radio-frequency neurotomy for chronic cervical zygapophyseal-joint pain. N Engl J Med 335:172117261996


Lozano AMVanderlinden GBachoo RRothbart P: Microsurgical C-2 ganglionectomy for chronic intractable occipital pain. J Neurosurg 89:3593651998


Mailis AFurlan A: Sympathectomy for neuropathic pain. Cochrane Database Syst Rev 2:CD0029182003


McDonald GJLord SMBogduk N: Long-term follow-up of patients treated with cervical radiofrequency neurotomy for chronic neck pain. Neurosurgery 45:61681999


Murali RRovit RL: Are peripheral neurectomies of value in the treatment of trigeminal neuralgia? An analysis of new cases and cases involving previous radiofrequency gasserian thermocoagulation. J Neurosurg 85:4354371996


Murphy JP: Occipital neurectomy in the treatment of headache. Results in 30 cases. Md State Med J 18:62661969


Nashold BS JrBullitt E: Dorsal root entry zone lesions to control central pain in paraplegics. J Neurosurg 55:4144191981


Nashold BS JrOstdahl RH: Dorsal root entry zone lesions for pain relief. J Neurosurg 51:59691979


Nashold BS JrVieira Jel-Naggar AO: Pain and spinal cysts in paraplegia: treatment by drainage and DREZ operation. Br J Neurosurg 4:3273351990


Niizuma HKwak RIkeda SOhyama HSuzuki JSaso S: Follow-up results of centromedian thalamotomy for central pain. Appl Neurophysiol 45:3243251982


North RBKidd DHCampbell JNLong DM: Dorsal root ganglionectomy for failed back surgery syndrome: a 5-year follow-up study. J Neurosurg 74:2362421991


Obrador SBravo G: Thalamic lesions for the treatment of facial neuralgias. J Neurol Neurosurg Psychiatry 23:3513521960. (Abstract)


Oh WSShim JC: A randomized controlled trial of radiofrequency denervation of the ramus communicans nerve for chronic discogenic low back pain. Clin J Pain 20:55602004


Onofrio BMCampa HK: Evaluation of rhizotomy. Review of 12 years' experience. J Neurosurg 36:7517551972


Osgood CPDujovny MFaille RAbassy M: Microsurgical lumbosacral ganglionectomy, anatomic rationale, and surgical results. Acta Neurochir (Wien) 35:1972041976


Oturai ABJensen KEriksen JMadsen F: Neurosurgery for trigeminal neuralgia: comparison of alcohol block, neurectomy, and radiofrequency coagulation. Clin J Pain 12:3113151996


Pevsner YShabat SCatz AFolman YGepstein R: The role of radiofrequency in the treatment of mechanical pain of spinal origin. Eur Spine J 12:6026052003


Pickett GEBisnaire DFerguson GG: Percutaneous retrogasserian glycerol rhizotomy in the treatment of tic douloureux associated with multiple sclerosis. Neurosurgery 56:5375452005


Pieper DRDickerson JHassenbusch SJ: Percutaneous retrogasserian glycerol rhizolysis for treatment of chronic intractable cluster headaches: long-term results. Neurosurgery 46:3633702000


Pillay PKHassenbusch SJ: Bilateral MRI-guided stereotactic cingulotomy for intractable pain. Stereotact Funct Neurosurg 59:33381992


Pollock BEEcker RD: A prospective cost-effectiveness study of trigeminal neuralgia surgery. Clin J Pain 21:3173222005


Porter RWHohmann GWBors EFrench JD: Cordotomy for pain following cauda equina injury. Arch Surg 92:7657701966


Powers SKAdams JEEdwards MSBoggan JEHosobuchi Y: Pain relief from dorsal root entry zone lesions made with argon and carbon dioxide microsurgical lasers. J Neurosurg 61:8418471984


Powers SKBarbaro NMLevy RM: Pain control with laserproduced dorsal root entry zone lesions. Appl Neurophysiol 51:2432541988


Prestor B: Microsurgical junctional DREZ coagulation for treatment of deafferentation pain syndromes. Surg Neurol 56:2592652001


Preventive Services Task Force: Guide to Clinical Preventive Services: Report of the U.S. Preventive Services Task Force ed 2BaltimoreWilliams & Wilkins1996


Probst C: Microsurgical cordotomy in 20 patients with epi-/intradural fibrosis following operation for lumbar disc herniation. Acta Neurochir (Wien) 107:30361990


Quinn JHWeil T: Trigeminal neuralgia: treatment by repetitive peripheral neurectomy. Supplemental report. J Oral Surg 33:5915951975


Raskind R: Analytical review of open cordotomy. Int Surg 51:2262311969


Raslan AMMcCartney SBurchiel KJ: Management of chronic severe pain: cerebral neuromodulatory and neuroablative approaches. Acta Neurochir Suppl 97:17262007


Raslan AMMcCartney SBurchiel KJ: Management of chronic severe pain: spinal neuromodulatory and neuroablative approaches. Acta Neurochir Suppl 97:33412007


Rath SABraun VSoliman NAntoniadis GRichter HP: Results of DREZ coagulations for pain related to plexus lesions, spinal cord injuries and postherpetic neuralgia. Acta Neurochir (Wien) 138:3643691996


Richardson DE: Thalamotomy for intractable pain. Confin Neurol 29:1391451967


Richter HPSeitz K: Dorsal root entry zone lesions for the control of deafferentation pain: experiences in ten patients. Neurosurgery 15:9569591984


Rosomoff HL: Bilateral percutaneous cervical radiofrequency cordotomy. J Neurosurg 31:41461969


Samii MBear-Henney SLudemann WTatagiba MBlomer U: Treatment of refractory pain after brachial plexus avulsion with dorsal root entry zone lesions. Neurosurgery 48:126912772001


Samii MMoringlane JR: Thermocoagulation of the dorsal root entry zone for the treatment of intractable pain. Neurosurgery 15:9539551984


Sanders MZuurmond WW: Efficacy of sphenopalatine ganglion blockade in 66 patients suffering from cluster headache: a 12- to 70-month follow-up evaluation. J Neurosurg 87:8768801997


Sapir DAGorup JM: Radiofrequency medial branch neurotomy in litigant and nonlitigant patients with cervical whiplash: a prospective study. Spine 26:E268E2732001


Schvarcz JR: Postherpetic craniofacial dysaesthesiae: their management by stereotaxic trigeminal nucleotomy. Acta Neurochir (Wien) 38:65721977


Schvarcz JR: Spinal cord stereotactic techniques re trigeminal nucleotomy and extralemniscal myelotomy. Appl Neurophysiol 41:991121978


Schvarcz JR: Stereotactic trigeminal tractotomy. Confin Neurol 37:73771975


Scoville WB: Extradural spinal sensory rhizotomy. J Neurosurg 25:94951966


Scrivani SJKeith DAMathews ESKaban LB: Percutaneous stereotactic differential radiofrequency thermal rhizotomy for the treatment of trigeminal neuralgia. J Oral Maxillofac Surg 57:1041121999


Sharma T: Abolition of opiate hunger in humans following bilateral anterior cingulotomy. Tex Med 70:49521974


Shieff CNashold BS Jr: Stereotactic mesencephalic tractotomy for thalamic pain. Neurol Res 9:1011041987


Shieff CNashold BS Jr: Thalamic pain and stereotactic mesencephalotomy. Acta Neurochir Suppl (Wien) 42:2392421988


Siegfried J: 500 Percutaneous thermocoagulations of the Gasserian ganglion for trigeminal pain. Surg Neurol 8:1261311977


Sindou MMertens PWael M: Microsurgical DREZotomy for pain due to spinal cord and/or cauda equina injuries: long-term results in a series of 44 patients. Pain 92:1591712001


Sindou MPBlondet EEmery EMertens P: Microsurgical lesioning in the dorsal root entry zone for pain due to brachial plexus avulsion: a prospective series of 55 patients. J Neurosurg 102:101810282005


Slappendel RCrul BJBraak GJGeurts JWBooij LHVoerman VF: The efficacy of radiofrequency lesioning of the cervical spinal dorsal root ganglion in a double blinded randomized study: no difference between 40 degrees C and 67 degrees C treatments. Pain 73:1591631997


Smith FP: Trans-spinal ganglionectomy for relief of intercostal pain. J Neurosurg 32:5745771970


Sourek K: Commissural myelotomy. J Neurosurg 31:5245271969


Spaic MPetkoviæ STadiæ RMiniæ L: DREZ surgery on conus medullaris (after failed implantation of vascular omental graft) for treating chronic pain due to spine (gunshot) injuries. Acta Neurochir (Wien) 141:130913121999


Spiegel EAWycis HT: Mesencephalotomy in treatment of intractable facial pain. AMA Arch Neurol Psychiatry 69:1131953


Staender MMaerz UTonn JCSteude U: Computerized tomography-guided kryorhizotomy in 76 patients with lumbar facet joint syndrome. J Neurosurg Spine 3:4444492005


Stechison MTMullin BB: Surgical treatment of greater occipital neuralgia: an appraisal of strategies. Acta Neurochir (Wien) 131:2362401994


Stovner LJKolstad FHelde G: Radiofrequency denervation of facet joints C2-C6 in cervicogenic headache: a randomized, double-blind, sham-controlled study. Cephalalgia 24:8218302004


Taha JMTew JM Jr: Comparison of surgical treatments for trigeminal neuralgia: reevaluation of radiofrequency rhizotomy. Neurosurgery 38:8658711996


Taha JMTew JM Jr: Long-term results of radiofrequency rhizotomy in the treatment of cluster headache. Headache 35:1931961995


Taha JMTew JM JrBuncher CR: A prospective 15-year follow up of 154 consecutive patients with trigeminal neuralgia treated by percutaneous stereotactic radiofrequency thermal rhizotomy. J Neurosurg 83:9899931995


Tasker RRStereotactic medial thalamotomy for chronic pain: is it an effective procedure?. Burchiel KJ: Surgical Management of Pain New YorkThieme Medical Publishers2002. 812820


Tasker RRDeCarvalho GTDolan EJ: Intractable pain of spinal cord origin: clinical features and implications for surgery. J Neurosurg 77:3733781992


Taub ARobinson FTaub E: Dorsal root ganglionectomy for intractable monoradicular sciatica. A series of 61 patients Stereotact Funct. Neurosurg 65:1061101995


Thomas DGJones SJ: Dorsal root entry zone lesions (Nashold's procedure) in brachial plexus avulsion. Neurosurgery 15:9669681984


Thomas DGKitchen ND: Long-term follow up of dorsal root entry zone lesions in brachial plexus avulsion. J Neurol Neurosurg Psychiatry 57:7377381994


Tomas RHaninec P: Dorsal root entry zone (DREZ) localization using direct spinal cord stimulation can improve results of the DREZ thermocoagulation procedure for intractable pain relief. Pain 116:1591632005


Tucker SMTarlov EC: Intraorbital surgery for trigeminal neuralgia. Ophthal Plast Reconstr Surg 21:11152005


Turnbull IM: Bilateral cingulumotomy combined with thalamotomy or mesencephalic tractotomy for pain. Surg Gynecol Obstet 134:9589621972


Turner JASears JMLoeser JD: Programmable intrathecal opioid delivery systems for chronic noncancer pain: a systematic review of effectiveness and complications. Clin J Pain 23:1801952007


Tzaan WCTasker RR: Percutaeous radiofrequency facet rhizotomy—experience with 118 procedures and reappraisal of its value. Can J Neurol Sci 27:1251302000


van Kleef MBarendse GAKessels AVoets HMWeber WEde Lange S: Randomized trial of radiofrequency lumbar facet denervation for chronic low back pain. Spine 24:193719421999


van Kleef MLiem LLousberg RBarendse GKessels FSluijter M: Radiofrequency lesion adjacent to the dorsal root ganglion for cervicobrachial pain: a prospective double blind randomized study. Neurosurgery 38:112711321996


van Suijlekom HAvan Kleef MBarendse GASluijter MESjaastad OWeber WE: Radiofrequency cervical zygapophyseal joint neurotomy for cervicogenic headache: a prospective study of 15 patients. Funct Neurol 13:2973031998


Voris HCWhisler WW: Results of stereotaxic surgery for intractable pain. Confin Neurol 37:86961975


Walchenbach RVoormolen JHHermans J: Microvascular decompression for trigeminal neuralgia: a critical reappraisal. Clin Neurol Neurosurg 96:2902951994


Wallis BJLord SMBogduk N: Resolution of psychological distress of whiplash patients following treatment by radiofrequency neurotomy: a randomised, double-blind, placebocontrolled trial. Pain 73:15221997


Wetzel FTPhillips FMAprill CNBernard TN JrLaRocca HS: Extradural sensory rhizotomy in the management of chronic lumbar radiculopathy: a minimum 2-year follow-up study. Spine 22:228322921997


White JCKjellberg RN: Posterior spinal rhizotomy: a substitute for cordotomy in the relief of localized pain in patients with normal life-expectancy. Neurochirurgia (Stuttg) 16:1411701973


Wilkinson HAChan AS: Sensory ganglionectomy: theory, technical aspects, and clinical experience. J Neurosurg 95:61662001


Wilkinson HADavidson KMDavidson RI: Bilateral anterior cingulotomy for chronic noncancer pain. Neurosurgery 45:112911361999


Wilson DHChang AE: Bilateral anterior cingulectomy for the relief of intractable pain. Report of 23 patients. Confin Neurol 36:61681974


Wycis HTFolkerts JFSpiegel EA: Treatment of postherpetic trigeminal neuralgia by mesencephalotomy or combined nesencephalothalamotomy. Zentralbl Neurochir 18:1882011958


Wycis HTSpiegel EA: Long-range results in the treatment of intractable pain by stereotaxic midbrain surgery. J Neurosurg 19:1011071962


Yen CPKung SSSu YFLin WCHowng SLKwan AL: Stereotactic bilateral anterior cingulotomy for intractable pain. J Clin Neurosci 12:8868902005


Yoon KBWiles JRMiles JBNurmikko TJ: Long-term outcome of percutaneous thermocoagulation for trigeminal neuralgia. Anaesthesia 54:8038081999


Young RF: Clinical experience with radiofrequency and laser DREZ lesions. J Neurosurg 72:7157201990


Young RFVermeulen SSGrimm PPosewitz AEJacques DBRand RW: Gamma Knife thalamotomy for the treatment of persistent pain. Stereotact Funct Neurosurg 64:1 Suppl1721811995


Zakrzewska JMJassim SBulman JS: A prospective, longitudinal study on patients with trigeminal neuralgia who underwent radiofrequency thermocoagulation of the Gasserian ganglion. Pain 79:51581999


Zapletal B: Open mesencephalotomy and thalamotomy for intractable pain. Acta Neurochir (Wien) Suppl 18:111191969


Ziccardi VBJanosky JEPatterson GTJannetta PJ: Peripheral trigeminal nerve surgery for patients with atypical facial pain. J Craniomaxillofac Surg 22:3553601994


Zorman GWilson CB: Outcome following microsurgical vascular decompression or partial sensory rhizotomy in 125 cases of trigeminal neuralgia. Neurology 34:136213651984




All Time Past Year Past 30 Days
Abstract Views 21 21 17
Full Text Views 160 160 32
PDF Downloads 131 131 23
EPUB Downloads 0 0 0


Google Scholar