Talamotomía estereotáxica por resonancia magnética para el tratamiento del dolor neural

INTRODUCTION Medial thalamotomy is one of the first stereotactic operations to have been used for neurogenic pain, has a low complication rate and no risk of the development of iatrogenic neurogenic pain. It represents selective local relief for all types of pain, without causing somatosensorial deficit. PATIENTS AND METHODS We did 39 posteromedial thalamotomies in patients with persistent intractable pain due to various disorders. The pain was assessed pre- and postoperatively on the VAS (Visual Analogic Scale). RESULTS Half of the patients operated on had relief of pain after thalamotomy. In 84% (n = 39) of our cases this relief occurred on the second day, in 70% (n = 35) after three months, in 63% (n = 27) after six months, in 64% (n = 25) after nine months, in 62% (n = 23) of the patients after 12 months, and in 62% (n = 22) after 24 months. Three patients had temporary complications and one a permanent complication, but this did not make him an invalid. CONCLUSION Posteromedial stereotactic thalamotomy under MR guidance can provide safe, effective treatment for persistent, intractable pain.