Neurosurgery
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Thirty-one patients suffering from intractable pain associated with chronic low back syndrome, cancer, and other disorders have been studied after an average of 6 months of treatment by electrical stimulation of the spinal cord applied using electrodes inserted through a Touhy needle into the epidural space. As judged by three different subjective rating methods, epidrual stimulation successfully relieved otherwise intractable chronic pain in from 23 to 26 of the 31 patients. Reported improvements in the ability to perform various everyday activities, and elimination of drug usage by many patients, corroborated this finding.
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Experimental hydromyelia and syringomyelia, induced by kaolin in dogs, has been investigated by scanning electron microscopy. This study demonstrated that communication between the 4th ventricle and the spinal central canal is normally occluded by a plug of acellular material lying within the central canal. ⋯ The canal distends and ruptures dorsally into the spinal gray matter with the development of extensive intramedullary cavities, lined by glial and neuronal elements. The morphological changes demonstrated are consistent with a physical destructive process of the cord resulting from CSF dissection.