Pain Neurosurgery

Indispensable for both the trainee and experienced professional, this is the only truly comprehensive account of the major role of the neurosurgeon in the diagnosis and treatment of chronic pain. The elite panel of contributors were chosen due to their expertise and international reputations. The result of their achievement covers the whole spectrum from criteria for patient selection and the details of operative techniques, to the risks, complications, and expected outcomes for a wide variety of anatomic, ablative, and augmentative neurosurgical procedures in treating chronic, intractable pain. The neurosurgeon will find here chapters on the latest neuroaugmentative advances utilizing electrical stimulation and implantable drug infusion systems as well as a useful section providing algorithms and guidelines for the evaluation and treatment of specific pain syndromes. Over 100 photographs and exquisite line drawings - many specifically commissioned for this book - enhance the text. Invaluable for acquiring the critical judgement and clinical skills necessary to apply the procedures involved.

Part of the Neurosurgery by Example series, this volume on pain neurosurgery presents exemplary cases in which renowned authors guide readers through the assessment and planning, decision making, surgical procedure, after care, and complication management of common and uncommon disorders. The cases explore the spectrum of clinical diversity and complexity within pain neurosurgery, including trigeminal neuralgia, postherpetic neuralgia, occipital neuralgia, percutaneous cordotomy for cancer-associated pain, chronic lumbar radiculopathy, and more. Each chapter also contains 'pivot points' that illuminate changes required to manage patients in alternate or atypical situations, and pearls for accurate diagnosis, successful treatment, and effective complication management. Containing a focused review of medical evidence and expected outcomes, Pain Neurosurgery is appropriate for neurosurgeons who wish to learn more about a subspecialty, and those preparing for the American Board of Neurological Surgery oral examination.

This issue provides a glimpse into how pain can be assessed and managed by several medical disciplines and approaches. It covers classical and conventional techniques as well as innovative techniques.

Ronald Brisman, M.D. This book will discuss three areas where the The multiplicity of procedures with varying neurosurgeon may provide an important degrees of risks and benefits sometimes re contribution to the relief of intractable pain: quires a sequential approach, but always an trigeminal and other facial neuralgias, chronic individual one, matching an appropriate treat noncancer pain, and cancer pain. By one ment plan or procedure for a particular patient intervention, the neurosurgeon often may pro at a specific time in his or her illness. vide long-lasting pain relief. New techniques, The neurosurgical chapters in this book which have developed since the 1970s and represent my experience with several hundred continue to evolve, dominate the neurosur patients during a 12-year period from 1975 gical armamentarium because they are not only through 1987. I have relied heavily on the effective, but safe. These include percutaneous works of others, which have been quoted from radio frequency electrocoagulation for trigem the neurosurgical literature, but this book is inal neuralgia, spinal stimulation for chronic not meant to be encyclopedic. noncancer pain, and intraspinal morphine in At least as important as knowing when to fusion for cancer pain. operate is knowing when not to do so, and this Sometimes a procedure relieves pain but the is particularly true of the treatment of pain. pain recurs; it may be necessary to repeat the Most patients with pain do not require neuro procedure, which in the case of radiofrequency surgical intervention.

Concise handbook on the surgical management of pain by internationally acclaimed neurosurgeon Functional neurosurgery has experienced unprecedented capabilities because of technological advances in neuroimaging, basic sciences, and increasingly sophisticated therapeutic interfaces. Intractable pain syndromes are among the most prevalent conditions, yet represent one of the most challenging areas of neurosurgery. Handbook of Pain Surgery, edited by esteemed functional neurosurgeon Kim J. Burchiel, explores the science and art of treating patients with intractable pain. The succinct text and videos provide a compact, reader-friendly guide on this unique neurosurgical subspecialty. Ten chapters on craniofacial pain encompass standard and newer approaches for the treatment of trigeminal neuralgia, including microvascular decompression, rhizotomy, neurectomy, stereotactic neurosurgery, percutaneous radiofrequency, percutaneous retrogasserian glycerol rhizolysis, and percutaneous balloon compression. Other sections detail spinal cord and peripheral nerve stimulation techniques, nonsurgical approaches, and destructive procedures such as dorsal rhizotomy and dorsal root ganglionectomy, CT-guided-cordotomy, and midline myelotomy. Key Highlights The use of spinal cord stimulation in the management of failed back surgery syndrome The pros and cons of nerve surgery for peripheral neuropathic pain An overview on intrathecal analgesic therapies including patient selection and implant techniques Innovative treatments for intractable pain such as dorsal root entry zone (DREZ) lesioning More than 130 superb color illustrations by Andy Rekito elucidate pain syndromes and procedures Videos posted in the Thieme MediaCenter provide further guidance on select surgical techniques Highly portable and affordable, this book is an ideal reference for hospitals rounds. It is essential reading for neurosurgical residents, fellows, and practicing neurosurgeons, in particular, those specializing in treating spinal, peripheral nerve, and craniofacial pain syndromes.

Not since White and Sweet published Pain and the Neurosurgeon in the 1960s has there been a comprehensive review of the entire field of neurosurgical pain management. You will find a complete synthesis of all current concepts of pain neuroanatomy, physiology, and pathophysiology; new procedures that minimize invasiveness and postoperative neurological deficits; and the entire scope of surgical and medical management of chronic pain. In addition, you will benefit from the expertise of the international board of contributors, a virtual who's who in pain medicine, management, and surgery. Special features of this encyclopedic resource: * Special Considerations highlighting important practical, clinical information * Point/Counterpoint giving the pros and cons of different treatment methods * Expert commentary offering insights and alternative views of each topic

Functional neurosurgery has experienced unprecedented capabilities because of technological advances in neuroimaging, basic sciences, and increasingly sophisticated therapeutic interfaces. Intractable pain syndromes are among the most prevalent conditions, yet represent one of the most challenging areas of neurosurgery. Handbook of Pain Surgery, edited by esteemed functional neurosurgeon Kim J. Burchiel, explores the science and art of treating patients with intractable pain. The succinct text and videos provide a compact, reader-friendly guide on this unique neurosurgical subspecialty. Ten chapters on craniofacial pain encompass standard and newer approaches for the treatment of trigeminal neuralgia, including microvascular decompression, rhizotomy, neurectomy, stereotactic neurosurgery, percutaneous radiofrequency, percutaneous retrogasserian glycerol rhizolysis, and percutaneous balloon compression. Other sections detail spinal cord and peripheral nerve stimulation techniques, nonsurgical approaches, and destructive procedures such as dorsal rhizotomy and dorsal root ganglionectomy, CT-guided-cordotomy, and midline myelotomy. Key Highlights The use of spinal cord stimulation in the management of failed back surgery syndrome The pros and cons of nerve surgery for peripheral neuropathic pain An overview on intrathecal analgesic therapies including patient selection and implant techniques Innovative treatments for intractable pain such as dorsal root entry zone (DREZ) lesioning More than 130 superb color illustrations by Andy Rekito elucidate pain syndromes and procedures Videos posted in the Thieme MediaCenter provide further guidance on select surgical techniques Highly portable and affordable, this book is an ideal reference for hospitals rounds. It is essential reading for neurosurgical residents, fellows, and practicing neurosurgeons, in particular, those specializing in treating spinal, peripheral nerve, and craniofacial pain syndromes.

This book presents the essential steps involved in diagnosing and treating pain due to peripheral nerve injury and compression. In the first chapter, the relevant anatomy and diagnostic tools to identify peripheral-nerve-related issues are described. The main part of the book, however, deals with the surgical techniques to address specific types of peripheral nerve pain, e.g. neuroma, thoracic outlet or migraine. A step-by-step, practical approach is provided, including important aspects to consider both pre- and post-op. The procedures presented are minimally-invasive and maximally effective. Each chapter features detailed surgical illustrations and anatomical images. Chronic pain control is a growing need and minimally invasive yet effective surgical techniques, combining the competences of neurosurgery, plastic surgery, orthopedics, general surgery, pain management and neurology are in high demand. The increasing demand on the part of patients suffering from neuropathic pain is to date not matched by adequate practical training in peripheral nerve surgery to control pain. The authors are experts in this discipline “from head to toe” and present a valuable guide that provides medical students and experienced clinicians alike with useful information for their daily practice.