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A myelotomy is a treatment option for patients with treatment resistant pain, especially when the pain affects the midline of the body. Although it is one of the more invasive procedures done for pain, it can provide the significant relief.

How Does it Work?

Pain signals that enter the spinal cord normally cross the midline before climbing up to the brain. The goal of this surgery is to interrupt these pain signals as they cross the midline of the spinal cord. The myelotomy procedure aims to interrupt abnormal signals before they get to climb up the spinal cord and into the brain. During the surgery, the spine is exposed and Dr Pouratian makes very precise cuts in the spine to interrupt the painful sensations. Specialized monitoring of the brain and spine is used throughout to maximize the safety of the procedure.

Am I A Good Candidate?

Myelotomy is a treatment option for individuals who have not found relief through other treatment options for chronic pain. In particular, myelotomy is most often considered for those patients with midline pain, particularly pelvic pain related to cancer.

The Procedure

The myelotomy procedure involves removal of the back part of the vertebral bones to expose the spine. The covering of the spine, or dura, is opened to expose the spine itself. Then, very precise incisions are made through the midline of the spinal cord to disrupt the transmission of pain signals to the brain.

The procedure can be immediately effective for the pain that it is targeting, with results in ~50-70% of patients. The most important risk of this surgery is a risk of weakness, which is why it is important to have an experienced surgeon do this surgery and to use the most advanced and experience spinal monitoring available.

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