Summary
Recent anatomic and physiologic work suggests that there may be substantial numbers of unmyelinated sensory axons in the ventral roots. The cell bodies of origin for these unmyelinated axons would presumably be located in the dorsal ganglion. We have performed 18 microsurgical lumbosacral ganglionectomies over the past two years for chronic lumbosacral pain syndromes. In spite of preoperative nerve block trials, good results were obtained in only 10 of 18 patients. Four patients obtained some pain relief, and four patients no pain relief whatsoever. Microganglionectomy in the lumbosacral area is probably easier technically than the more traditional intradural rhizotomy, but may not yield any better results.
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References
Bell, C., Idea of a new anatomy of the brain. London: Strahan and Preston. 1811.
Coggeshall, R. E., Appelbaum, M. L., Fazem, M., Stubbs, T. B. III, Sykes, M. T., Unmyelinated axons in human ventral roots, a possible explanation for the failure of dorsal rhizotomy to relieve pain. Brain98 (1975), 157–166.
—, Appelbaum, M. L., Fazem, M., Stubbs, T. B. III, Sykes, M. T., Clifton, G. L., Vance, W. H., Applebaum, M. L., Unmyelinated sensory fibers in the ventral root. Anatomical Record181 (1975), 334.
Coggeshall, R. E., Coulter, J. D., Willis, W. D., Jr., Unmyelinated fibers in the ventral root. Brain Research57 (1973), 229–233.
Echols, D. H., Sensory rhizotomy following operation for ruptured intravertebral disc. J. Neurosurg.31 (1969), 335–338.
Kato, M., Hirata, Y., Sensory neurons in the spinal ventral roots of the cat. Brain Research7 (1968), 479–482.
Loeser, J. D., Dorsal rhizotomy for the relief of chronic pain. J. Neurosurg.36 (1972), 745–750.
Magendie, F., Experiences sur les functions des racines des nerves rachidine. J. Physiol. Exp.1822, 276–279.
Matthews, M. A., An electron microscopic study of the relationship between axon diameter and the intiation of myelin production in the peripheral nervous system. Anat. Rec.161 (1968), 337–352.
McCabe, J. S., Low, E. N., The subarachnoid angle: An area of transition in the peripheral nerve. Anat. Rec.164 (1969), 15–34.
Onofrio, B. M., Campa, H. K., Evalution of rhizotomy: Review of 12 years experience. J. Neurosurg.36 (1972), 751–755.
Pallie, W., The intersegmental anastomoses of posterior spinal rootlets and their significance. J. Neurosurg.16 (1959), 188–196.
Patrizi, G., Poger, M., The ultrastructure of nuclear periphery. J. Ultrastruct. Res.17 (1967), 127–156.
Scoville, F. P., Extraduraral spinal sensory rhizotomy. J. Neurosurg.25 (1966), 94–95.
Smith, F. P., Trans-spinal ganglionectomy for relief of intercostal pain. J. Neurosurg.32 (1970), 574–577.
Webber, R. H., Wemett, A., Distribution of fibers from nerve cell bodies in ventral roots of spinal nerves. Acta Anat. (Basel)65 (1966), 579–583.
White, J. C., Kjellberg, R. N., Posterior spinal rhizotomy: A substitute for cordotomy in the relief of localized pain in patients with normal life expectancy. Neurochirurgia16 (1973), 141–170.
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Osgood, C.P., Dujovny, M., Faille, R. et al. Microsurgical lumbosacral ganglionectomy, anatomic rationale, and surgical results. Acta neurochir 35, 197–204 (1976). https://doi.org/10.1007/BF01405947
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DOI: https://doi.org/10.1007/BF01405947