Article

Intrathecal Injections of Alcohol or Phenol for Relief of Intractable Pain*

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Abstract

THE injection of alcohol into the subarachnoid space for the relief of chronic pain was described by Dogliotti in 1930, according to Hay, Yonezawa, and Derrick.1 The intrathecal injection of phenol mixed with glycerin or myodil was reported by Maher2 in 1955. Careful regulation of the concentration and amount of chemical used, as well as attention to pooling it about the roots that supply the dermatomes at the sites of pain will produce selective rhizotomy. Debilitated patients suffering from cancer with intractable pain,1–4 others with benign disease causing chronic neuralgias,3, 4 and spastic paraplegics with agonizing muscle spasms and painful frozen joints5, 6 have been helped by alcohol and phenol blocks. These procedures are significant contributions to the neurosurgeon’s armamentarium for pain relief.

This is a report on 62 injections administered to 36 patients, 29 of whom had metastatic cancer. The other seven patients had intractable pain with these diagnoses: neurofibromatosis, postherpetic neuralgia, myelopathy of unknown origin (two patients), lumbar chordoma, spastic paraplegia secondary to cerebral palsy, and spastic paraparesis secondary to syringomyelia. The location of pain was in the leg, lower back, and/or saddle area in these 36 patients. The frequency of area involvement was in the: leg or legs (3 patients); saddle (11 patients); lumbosacral region (one patient); lumbosacrum and legs (8 patients); lumbosacrum and saddle (3 patients); lumbosacrum, saddle, and legs (6 patients); legs and saddle (4 patients).

Technic for Alcohol Injections

With the patient in the prone position, preferably on a proctoscopic table with the head . . .


 

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