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THE TREATMENT OF PERSISTENT PAIN OF ORGANIC ORIGIN IN THE LOWER PART OF THE BODY BY DIVISION OF THE ANTEROLATERAL COLUMN OF THE SPINAL CORD

WILLIAM G. SPILLER, M.D.; EDWARD MARTIN, M.D.
JAMA. 1912;LVIII(20):1489-1490. doi:10.1001/jama.1912.04260050165001.
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REMARKS BY DR. SPILLER  Occasionally the pain from tumor of the cauda equina is so intense that complete division of the spinal cord has been suggested for its relief, and it is only recently that I have seen a case in which this measure had been proposed. If division of the anterolateral columns alone will remove pain, it may be possible, if the other parts of the cord be left intact, to avoid paralysis of the lower limbs and of the bowels and bladder by this operation. It probably would produce ataxia. Such an operation may be considered only in extreme cases when life has become almost a burden, because of severe suffering.A. Schüller1 has suggested that as a substitution operation partial division of the spinal cord might be employed instead of section of the posterior roots for spasticity and gastric crises. The posterior columns, he suggests, might

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