Spine Ablative Procedures

(1) midline pain pathway (2) Dorsal root entry zone (3) corticospinal tract (4) anterolateral spinothalamic tract (5) ventral white decussation)
(1) midline pain pathway (2) Dorsal root entry zone (3) corticospinal tract (4) anterolateral spinothalamic tract (5) ventral white decussation)

Cordotomy

Background

  • definition: interruption of anterolateral spinothalamic tract
  • Option: percutaneously at C1 or open in thoracic spinal cord.
  • must be ventral to dentate ligament (separates dorsally located corticospinal tract from the spinothalamic tract)

DREZ Lesioning Procedures

Background

  • dorsal root entry zone = target for DREZ lesioning procedures
 

Midline Myelotomy for Visceral Pain

(1) is the target for the midline myelotomy for visceral pain
 

Commissural Myelotomies

ventral white decussation (5) contains fibers from both spinothalamic tracts and is the target for commissural myelotomies.