Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1976 Jul;39(7):705–710. doi: 10.1136/jnnp.39.7.705

High cervical commissural myelotomy in the treatment of pain.

I Papo, A Luongo
PMCID: PMC492409  PMID: 1069098

Abstract

High cervical myelotomy was carried out on 10 patients. Commissurotomy was performed at the C1-3 level by a combined procedure of deep electrocogulation and sharp splitting of the posterior columns. The immediate results were excellent in all patients, but relapse of pain took place shortly in six of them; there was apparently no relation with the location of pain. No long-term favourable results were observed in this series. Only three patients exhibited a well-defined band of mild hypalgesia from C2 to T 10 dermatome, but it lasted for only three to four weeks. Transient lower or four limb ataxia was observed in seven patients. Different pain conducting systems seem to be affected by commissural myelotomy, but not to a sufficient extent to give permanent or long-lasting relief of pain. The indications for high cervical myelotomy are very limited: this procedure should be considered only in patients with unilateral or bilateral arm and/or upper chest pain, respiratory impairment, and short life expectancy.

Full text

PDF
705

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BELMUSTO L., BROWN E., OWENS G. CLINICAL OBSERVATIONS ON RESPIRATORY AND VASOMOTOR DISTURBANCE AS RELATED TO CERVICAL CORDOTOMIES. J Neurosurg. 1963 Mar;20:225–232. doi: 10.3171/jns.1963.20.3.0225. [DOI] [PubMed] [Google Scholar]
  2. Broager B. Commissural myelotomy. Surg Neurol. 1974 Mar;2(2):71–74. [PubMed] [Google Scholar]
  3. DARGENT M., MANSUY L., COLON J., de ROUGEMONT [Problems posed by pain in the development of gynecologic cancers]. Lyon Chir. 1963 Jan;59:62–83. [PubMed] [Google Scholar]
  4. Hitchcock E., Leece B. Somatotopic representation of the respiratory pathways in the cervical cord of man. J Neurosurg. 1967 Oct;27(4):320–329. doi: 10.3171/jns.1967.27.4.0320. [DOI] [PubMed] [Google Scholar]
  5. Hitchcock E. Stereotactic cervical myelotomy. J Neurol Neurosurg Psychiatry. 1970 Apr;33(2):224–230. doi: 10.1136/jnnp.33.2.224. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hitchcock E. Stereotactic myelotomy. Proc R Soc Med. 1974 Aug;67(8):771–772. doi: 10.1177/003591577406700840. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. LEMBCKE W. UBER DIE MEDIOLONGITUDINALE CHORDOTOMIE IM HALSMARKBEREICH. Zentralbl Chir. 1964 Mar 28;89:439–443. [PubMed] [Google Scholar]
  8. Lippert R. G., Hosobuchi Y., Nielsen S. L. Spinal commissurotomy. Surg Neurol. 1974 Nov;2(6):373–377. [PubMed] [Google Scholar]
  9. Richards D. E., Tyner C. F., Shealy C. N. Focused ultrasonic spinal commissurotomy: experimental evaluation. J Neurosurg. 1966 Apr;24(4):701–707. doi: 10.3171/jns.1966.24.4.0701. [DOI] [PubMed] [Google Scholar]
  10. Shealy C. N., Tyner C. F., Taslitz N. Physiological evidence of bilateral spinal projections of pain fibers in cats and monkeys. J Neurosurg. 1966 Apr;24(4):708–713. doi: 10.3171/jns.1966.24.4.0708. [DOI] [PubMed] [Google Scholar]
  11. Taren J. A., Davis R., Crosby E. C. Target physiologic corroboration in stereotaxic cervical cordotomy. J Neurosurg. 1969 May;30(5):569–584. doi: 10.3171/jns.1969.30.5.0569. [DOI] [PubMed] [Google Scholar]
  12. WERTHEIMER P., LECUIRE J. La myélotomie commissurale postérieure, a propos de 107 observations. Acta Chir Belg. 1953 Jun;52(6):568–574. [PubMed] [Google Scholar]
  13. Zlatos J., Cierny G., Nádvorník P. A contribution to the topometry of the spinal cord. Confin Neurol. 1971;33(6):342–349. doi: 10.1159/000103150. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES