Neurosurgical Management of Intractable Pain
Defining the Scope of the Problem
Evaluation of the Chronic Pain Patient
Multidisciplinary
Approach
Dedicated Pain Clinic
Specialists
Multidisciplinary
Approach
Ancillary Staff
Selection Criteria for Implantable Neuromodulation Therapy
Spinal Cord
Stimulation
Clinical Applications
Spinal Cord
Stimulation
Patient Selection
Spinal Cord
Stimulation
Stage I - Screening Trial
"“Effective pain relief is..."
Spinal Cord
Stimulation
Results and Outcomes
Spinal Cord Stimulation for Angina
SCS for Peripheral Vascular Disease
SCS for Peripheral Vascular Disease
Stimulation of Spinal Nerve Roots
Deep Brain Stimulation
Clinical
Indications
Indications for Spinal Opiates
Contraindications to Spinal Opiates
Spinal Opiate Therapy
Additional
Considerations
Spinal Opiate Screening Trials
Morphine Screening
Trial
Continuous Infusion
Non- Opiate Agents for IT Infusion
Intraspinal Drug
Infusion
General Guidelines
Clinical Guidelines for Intraspinal Drug Infusion
Clinical Guidelines for Intraspinal Drug Infusion
Clinical Guidelines for Intraspinal Drug Infusion
Clinical Guidelines for Intraspinal Drug Infusion
Ablative Surgery
Disadvantages
Dorsal Root Ganglionectomy
(DRG)
Physiological Basis
Dorsal Root Entry Zone (DREZ) Lesion
Open Anterolateral
Cordotomy
Results and Complications
Percutaneous Cordotomy Correlative Anatomy
Percutaneous C1-2
Cordotomy
Classical Technique
Percutaneous Cordotomy
Classical Technique
CT-Guided Percutaneous Cordotomy
Percutaneous Cordotomy
Results
- Unilateral Procedure
Percutaneous Cordotomy
Results
- Bilateral Procedures
Midline (Commissural) Myelotomy