[Neurosurgical indications in the treatment of chronic pain]

Better knowledge in the transmission of pain signals, clinical analysis of pain allowing its aetiopathogenic interpretation (neurogenic pain, somatogenic pain), and technical improvements in neurosurgical interventions that have now become non-traumatic, increasingly selective with less and less general anaesthesia and without prolonged hospitalization, most often allowing precise postoperative control of the intervention, have given neurosurgery a fresh impetus and a major place in the multidisciplinary therapeutic approach to chronic pain. From being exclusively destructive, the neurosurgery of chronic pain has acquired a resolutely conservative orientation with a neurophysiological approach (therapeutic neurostimulation methods) as well as a broader range via a biochemical approach (drug application in the vicinity of neuromediator receptors).