Christiaens J L
Bull Cancer. 1980;67(2):222-4.
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.
当其他治疗方法均告失败时，可考虑采用神经外科方法治疗癌痛。这需要对疼痛的所有参数进行仔细研究，并根据每个病例的具体情况进行调整。这种治疗的决策与所选的手术方法同样重要。必须仔细了解患者的心理特征。除非在手术显微镜的辅助下进行，否则切断神经结构的外科手术（脊髓丘脑束切断术、神经根切断术）正逐渐被淘汰。此时，应采用在放射影像学和电生理控制下的经皮技术（加塞神经节）以及脑立体定向技术（中脑切开术）。脊髓后柱刺激或深部脑刺激技术应用时间尚短，目前还难以得出明确结论。
