Abstract
Neurosurgery can play a role in the management of patients with refractory chronic neuropathic pain. However, selecting patients as candidates for surgery and choosing the most appropriate surgical procedure is challenging, and surgical interventions often have limited efficacy. When considering surgery, neuroaugmentative or neuromodulative procedures (eg, peripheral, spinal, motor cortex or deep brain stimulation) are generally preferred over ablative procedures as initial modalities. With better understanding of specific pain mechanisms, surgery will have more to offer patients with chronic neuropathic pain.
Highlights
RÉSUMÉ : La neurochirurgie peut jouer un rôle dans la prise en charge des patients souffrant d’une douleur neuropathique chronique réfractaire
Chronic pain has been defined as pain that lasts longer than three to six months or, as proposed by the International Association for the Study of Pain
It is classified as ‘peripheral type’ when it results from neural injury or dysfunction from peripheral sources or as ‘central type’, when it arises from dysfunction in the brain and spinal cord
Summary
Neurosurgery can play a role in the management of patients with refractory chronic neuropathic pain. Selecting patients as candidates for surgery and choosing the most appropriate surgical procedure is challenging, and surgical interventions often have limited efficacy. Neuroaugmentative or neuromodulative procedures (eg, peripheral, spinal, motor cortex or deep brain stimulation) are generally preferred over ablative procedures as initial modalities. With better understanding of specific pain mechanisms, surgery will have more to offer patients with chronic neuropathic pain
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