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Abstract:
Neurosurgical management of cancer pain is indicated when other therapeutic methods have failed. It requires a careful investigation of all the parameters of pain and an adaptation to suit each individual case. The decision of such a treatment is as important as the chosen procedure. The psychological features must be carefully known. The surgical procedures of sectioning nervous structures (spino-thalamic cordotomy, rhizotomy), unless they are done with the help of the operating microscope, are slowly being abandoned. Percutaneous techniques under radiographic and electrophysiological control (Gasser ganglion) and cerebral stereotaxic techniques (mesencephalotomy) are there indicated. Stimulation of th dorsal columns of the spinal cord or deep brain stimulation are too recent to demonstrate a definite opinion.