Discussion of the indications for decompressive laminectomy in epidural spinal metastases.

The authors have recently reviewed the results of their consecutive cases of decompressive thoracic or lumbar laminectomy for spinal cord compression from epidural metastatic neoplasia at the City of Hope National Medical Center over the 15-year period, 1960-1974. This limited series tends to demonstrate the effect of case selection on results, as well as contrast the type of patient with paraparesis seen at a cancer treatment center with that seen at a community or county hospital.

What is a pain center?

The authors present the concept that a multi-disciplinary interdepartmental pain center should include: 1) an initial out-patient pain clinic, 2) an inpatient pain service for diagnosis of pain problems and treatment of patients with intractable pain, including pain from cancer, 3) a psychotherapeutically-oriented chronic benign Pain Unit, 4) facilities for clinical and basic pain research, and 5) affiliations for an adequate teaching program.

Needle scope attached to stereotactic frame for inspection of cisterna magna during percutaneous radiofrequency trigeminal tractotomy.

Use of a fiber optic needle scope attached to the Todd-Wells stereotactic unit has facilitated electrode placement during percutaneous trigeminal tractotomy.