Surgical functional treatment of pain

Abstract

Many functional neurocirurgical procedures are useful in patients with muscleskeletal pains. The surgical descompression of roots or nerve trunks are indicated in
cases of stenosis of the pathways of these structures due to inflammatory, degenerative or oncologic lesions fractures or bone deformities or oncologic lesions. Sympatectomies are not very effective in cases of tipe II complex regional pain syndromes; facet rhyzotomies are efficient in cases of cervicalgia, dorsalgia and lombalgia due to myofascial pain syndromes, thermal disc nucleolysis are efficient in cases of lombalgia due to discal pains; DREZ is usefful in the treatment of neuropathic pains and spasticity; mesencephalotomies, thalamotomies and psychosurgeries
are efficient in difficult cases. Endocrinological ablative procedures including hypofisectomies are efficient in cases of bone pains resulting from secondaries of prostate, breast and
endometrium. Except for post-laminectomies pains or neuropatic pains, the stimulation of the central nervous stystem are not appropriate for treatment of muscleskeletal pains. The infusion of morphine is a very effective method for treatment of the majority of muscle skeletal pain.