Book contents
- Frontmatter
- Contents
- Preface
- 1 Discovery of the anterolateral system and its role as a pain pathway
- 2 Organization of the central pain pathways
- 3 Physiology of cells of origin of spinal cord and brainstem projections
- 4 Physiology of supraspinal pain-related structures
- 5 Functional brain imaging of acute pain in healthy humans
- 6 Pain modulatory systems
- 7 Peripheral and central mechanisms and manifestations of chronic pain and sensitization
- 8 Functional imaging of chronic pain
- 9 Functional implications of spinal and forebrain procedures for the treatment of chronic pain
- Index
- References
1 - Discovery of the anterolateral system and its role as a pain pathway
Published online by Cambridge University Press: 05 October 2010
Book contents
- Frontmatter
- Contents
- Preface
- 1 Discovery of the anterolateral system and its role as a pain pathway
- 2 Organization of the central pain pathways
- 3 Physiology of cells of origin of spinal cord and brainstem projections
- 4 Physiology of supraspinal pain-related structures
- 5 Functional brain imaging of acute pain in healthy humans
- 6 Pain modulatory systems
- 7 Peripheral and central mechanisms and manifestations of chronic pain and sensitization
- 8 Functional imaging of chronic pain
- 9 Functional implications of spinal and forebrain procedures for the treatment of chronic pain
- Index
- References
Summary
Introduction
On January 19 1911, persuaded by his colleague, the neurologist William Spiller, a Philadelphia surgeon named Edward Martin made a small transverse cut in the spinal cord of a patient suffering from severe pain caused by a tumor affecting the lower end of the spinal column. The cut, made with a thin cataract knife, was no more than 2 mm deep or wide and entered the cord some 3 mm ventral to the entry of a dorsal root in the middle thoracic region. The patient experienced much relief from what had until then been intractable pain (Spiller and Martin,1912). The operation of “chordotomie” or section of the anterolateral tracts of the spinal cord had been introduced in 1910 by Schüller in work on monkeys in which he was exploring the possibility of using the operation for the alleviation of spastic paralysis and tabetic crises in humans. Spiller argued for the procedure on the basis of clinico-pathological observations that appeared to implicate the anterolateral tracts as pathways for conduction of impulses related to pain and temperature through the spinal cord (Müller, 1871; Gowers, 1879; Spiller, 1905; Petrén, 1910). Reports of other successful cases quickly followed (Beer, 1913; Foerster, 1913) and soon, at the hands of Foerster (1913, 1927; Foerster and Gagel, 1932) in Germany and Frazier (1920) in the United States, cordotomy was to become for a time the surgical method of choice in dealing with intractable pain.
- Type
- Chapter
- Information
- The Human Pain SystemExperimental and Clinical Perspectives, pp. 1 - 63Publisher: Cambridge University PressPrint publication year: 2010
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