Book contents
- Frontmatter
- Contents
- Contributors
- Preface
- I Introduction
- II Vascular disorders
- III Trauma to the central nervous system
- IV Tumours
- V Degenerative disease
- VI Infections of the central nervous system
- VII Epilepsy, coma and other syndromes
- VIII Surgery for movement disorders and pain
- 26 Neurosurgical treatment of pain syndromes
- 27 Neurosurgical treatment for pain: trigeminal neuralgia
- 28 Neurosurgical treatment for pain: spinal cord stimulation
- 29 Stereotactic surgery for movement disorder
- IX Rehabilitation
- Index
26 - Neurosurgical treatment of pain syndromes
from VIII - Surgery for movement disorders and pain
Published online by Cambridge University Press: 02 December 2009
- Frontmatter
- Contents
- Contributors
- Preface
- I Introduction
- II Vascular disorders
- III Trauma to the central nervous system
- IV Tumours
- V Degenerative disease
- VI Infections of the central nervous system
- VII Epilepsy, coma and other syndromes
- VIII Surgery for movement disorders and pain
- 26 Neurosurgical treatment of pain syndromes
- 27 Neurosurgical treatment for pain: trigeminal neuralgia
- 28 Neurosurgical treatment for pain: spinal cord stimulation
- 29 Stereotactic surgery for movement disorder
- IX Rehabilitation
- Index
Summary
Introduction
The problem of chronic pain, one of the most economically important issues in medicine, encompasses a vast array of disease states and neurosurgical procedures to treat it. This chapter reviews outcomes of surgery for chronic pain. Neurosurgical operations in regular use will be briefly reviewed, giving a brief summary of status for the relief of a particular disease state and then, in the form of tables, published, and where available, personal data on success rate and incidence of complications. The decision to review outcomes of particular procedures will be influenced by the author's experience and perception of overall contemporary significance. For example, the use of infusion pumps to administer morphine in pain patients is a medical procedure that will not be reviewed here.
Measurement of outcome
In stressing the importance of attempting to provide a database for outcomes, this volume has hit the nail on the head, a very sensitive and wobbly head at that in the case of these functional procedures. Outcomes in the therapy of head injury can be assessed by measurements of activities of everyday living; that in tumour surgery by the Karnovsky Scale and survival statistics. But semi-quantitative outcome assessment in pain disorders is not readily achieved. Chronic pain patients usually suffer from underlying disease states responsible for their pain in the first place and these influence outcome significantly. Moreover these disease processes are usually unpredictably progressive and as time goes on may induce new problems and different pain syndromes not envisaged at the time of original pain surgery.
- Type
- Chapter
- Information
- Outcomes in Neurological and Neurosurgical Disorders , pp. 481 - 506Publisher: Cambridge University PressPrint publication year: 1998