Related Experiment Video
Updated: Nov 27, 2025
07:44
Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for L5/S1 Adjacent Segment Foraminal Stenosis
Published on: October 17, 2025
189
Revisiting Forel Field Surgery
Jorge Guridi1, Lain Hermes Gonzalez-Quarante1
1Department of Neurosurgery, Clínica Universidad de Navarra, Navarra University, Pamplona, Spain.
World Neurosurgery
|December 4, 2020
Summary
Surgical lesioning of the Forel field and subthalamic region offers potential tremor control for movement disorders. Innovations like MRI-guided focused ultrasound may revive these classic targets for improved patient outcomes.
Area of Science:
- Neurosurgery
- Neurology
- Movement Disorders
Background:
- Forel field and subthalamic region lesioning were historical treatments for tremor.
- These techniques were alternatives to thalamotomy in the mid-20th century.
- Recent advancements in imaging and noninvasive ablative technologies have renewed interest in these targets.
Purpose of the Study:
- To conduct a comprehensive anatomical and surgical review of the subthalamic region.
- To provide an updated analysis of techniques and outcomes for tremor patients undergoing surgical interventions.
- To evaluate different surgical approaches for tremor management.
Main Methods:
- Systematic literature review of ablative or stimulation surgical techniques.
- Inclusion of studies targeting pallidothalamic pathways (tractotomy), cerebellothalamic pathway (tractotomy), or the subthalamic area.
- Analysis of surgical outcomes in patients with movement disorders.
Main Results:
- Pallidothalamic tractotomy targets pallidofugal pathways with a potentially favorable benefit/risk ratio.
- This approach may offer a lower risk of injury to critical structures compared to pallidotomy.
- Cerebellothalamic tractotomy and posterior subthalamic area are presented as alternative targets.
Conclusions:
- Magnetic resonance-guided focused ultrasound represents a significant neurosurgical advancement.
- Classic targets like the pallidothalamic tract, Forel field, and posterior subthalamic area warrant reconsideration.
- These targets may offer viable surgical alternatives for managing movement disorders.
