{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:46:22Z","timestamp":1786124782644,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T00:00:00Z","timestamp":1594339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    This is a surgical video of a computed tomography (CT)-guided percutaneous radiofrequency ablation of the spinal trigeminal tract and nucleus caudalis for refractory trigeminal neuropathic pain.\n                    <jats:sup>1,2<\/jats:sup>\n                  <\/jats:p>\n                  <jats:p>\n                    Many have contributed historically, among them, Sjoqvist\n                    <jats:sup>3<\/jats:sup>\n                    in 1938 first described destruction of the descending medullary trigeminal tractus via open craniotomy.\n                    <jats:sup>3-6<\/jats:sup>\n                    In 1967 and 1968, Crue\n                    <jats:sup>7<\/jats:sup>\n                    and Hitchcock\n                    <jats:sup>8<\/jats:sup>\n                    independently developed a percutaneous tractotomy technique. Although Kanpolat\n                    <jats:sup>9,10<\/jats:sup>\n                    first described the use of CT imaging for percutaneous creation of a single tractotomy\/nucleotomy lesion resulting in satisfactory pain relief for 85% of patients.\n                  <\/jats:p>\n                  <jats:p>\n                    The spinal trigeminal tract is a descending fiber pathway containing central processes of first-order afferent neurons from cranial nerves V, VII, IX, and X. The spinal trigeminal nucleus is the terminal projection of the spinal trigeminal tract comprised of 3 subnuclei: oralis, interpolaris, and caudalis. The nucleus caudalis is the most caudal of the 3 subdivisions of the spinal trigeminal nucleus and houses the cell bodies of second-order afferent neurons critical in nociception of the face. Lesioning of the spinal trigeminal tract and nucleus caudalis can provide pain relief without affecting facial sensation or trigeminal motor function.\n                    <jats:sup>9,11-13<\/jats:sup>\n                    Percutaneous radiofrequency ablation is performed using anatomical landmarks, serial CT scans, impedance monitoring, and functional confirmation to ensure appropriate insertion of the probe to the target of interest prior to lesioning.\n                  <\/jats:p>\n                  <jats:p>\n                    This procedure remains uncommon in current practices even among functional neurosurgery pain specialists but offers a low-risk, minimally invasive treatment option for refractory facial pain.\n                    <jats:sup>14<\/jats:sup>\n                  <\/jats:p>\n                  <jats:p>This procedure was done under Institutional Review Board guidance (H-41228: retrospective chart review of patients undergoing spine surgery for pain). The risks and benefits were explained, and the patient consented to videography\/procedure.<\/jats:p>\n                  <jats:p>Images in the video used with permission from the following: Carter HV. Anatomy of the Human Body. Wikimedia Commons [Public Domain]. https:\/\/commons.wikimedia.org\/wiki\/File:Gray698.png. Published 1918. Accessed June 30, 2019; Carter HV. Anatomy of the Human Body. Wikimedia Commons [Public Domain]. https:\/\/commons.wikimedia.org\/wiki\/File:Gray784.png. Published 1918. Accessed June 30, 2019; Reprinted from Kanpolat Y, Kahilogullari G, Ugur HC, Elhan AH, CT-guided percutaneous trigeminal tractotomy-nucleotomy, Neurosurgery, 2008, 63(1 Suppl 1), ONS147-53; discussion ONS153-5, by permission of the Congress of Neurological Surgeons; Madhero88. Onion Distribution of Pain and Temperature Sense by Trigeminal Nerve. Wikimedia Commons [Creative Commons BY 3.0 license]. https:\/\/en.wikipedia.org\/wiki\/File:Onionskinddistribution.svg#\/media\/File:Onionskinddistribution.svg. Accessed June 30, 2019.<\/jats:p>","DOI":"10.1093\/ons\/opaa188","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T13:08:41Z","timestamp":1594386521000},"page":"E530-E531","source":"Crossref","is-referenced-by-count":2,"title":["Percutaneous Computed Tomography-Guided Radiofrequency Ablation of Spinal Trigeminal Tract and Nucleus Caudalis for Refractory Trigeminal Neuropathic Pain: 2-Dimensional Operative Video"],"prefix":"10.1227","volume":"19","author":[{"given":"M Benjamin","family":"Larkin","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Y","family":"North","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwin","family":"Viswanathan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,11]]},"reference":[{"key":"bib1-20231031","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/978-3-7091-9297-9_33","article-title":"Trigeminal neuropathic pain","volume":"58","author":"Burchiel","year":"1993","journal-title":"Advances in Stereotactic and Functional Neurosurgery 10"},{"issue":"5","key":"bib2-20231031","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1227\/01.NEU.0000088806.11659.D8","article-title":"A new classification for facial pain","volume":"53","author":"Burchiel","year":"2003","journal-title":"Neurosurgery"},{"key":"bib3-20231031","first-page":"93","article-title":"Studies on pain conduction in the trigeminal nerve: A contribution to the surgical treatment of facial pain","volume":"17","author":"Sj\u00f6qvist","year":"1938","journal-title":"Acta Psychiatr Neurol Scand Suppl"},{"issue":"1-3","key":"bib4-20231031","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1159\/000102714","article-title":"Stereotactic trigeminal tractotomy","volume":"37","author":"Schvarcz","year":"1975","journal-title":"Confin Neurol"},{"issue":"1-4","key":"bib5-20231031","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1159\/000098916","article-title":"Trigeminal nucleus caudalis dorsal root entry zone: a new surgical approach","volume":"59","author":"Nashold","year":"1992","journal-title":"Stereotact Funct Neurosurg"},{"issue":"2","key":"bib7-20231031","first-page":"86","article-title":"Percutaneous trigeminal tractotomy. Case report-utilizing stereotactic radiofrequency lesion","volume":"32","author":"Crue","year":"1967","journal-title":"Bull Los Angeles Neurol Soc"},{"issue":"2","key":"bib8-20231031","first-page":"131","article-title":"Stereotactic trigeminal tractotomy","volume":"2","author":"Hitchcock","year":"1970","journal-title":"Ann Clin Res"},{"issue":"Suppl_1","key":"bib9-20231031","doi-asserted-by":"crossref","first-page":"ONS147","DOI":"10.1227\/01.NEU.0000320139.27501.69","article-title":"Computed tomography-guided percutaneous trigeminal tractotomy-nucleotomy","volume":"63","author":"Kanpolat","year":"2008","journal-title":"Oper Neurosurg"},{"issue":"3","key":"bib10-20231031","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1007\/BF01403596","article-title":"CT-guided trigeminal tractotomy","volume":"100","author":"Kanpolat","year":"1989","journal-title":"Acta Neurochir (Wien)"},{"issue":"2","key":"bib11-20231031","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s00276-000-0081-8","article-title":"Radiologic anatomy of the spinal dorsal horn at the cervical level (anatomic-MRI correlations)","volume":"22","author":"Mertens","year":"2000","journal-title":"Surg Radiol Anat"},{"issue":"4","key":"bib12-20231031","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1097\/00006123-200204000-00025","article-title":"Neurophysiological monitoring for the nucleus caudalis dorsal root entry zone operation","volume":"50","author":"Husain","year":"2002","journal-title":"Neurosurgery"},{"issue":"128","key":"bib13-20231031","article-title":"Nucleus caudalis lesioning: Case report of chronic traumatic headache relief","volume":"2","author":"Sandwell","year":"2011","journal-title":"Surg Neurol Int"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/19\/5\/E530\/33855801\/opaa188.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opaa188","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:45:39Z","timestamp":1786121139000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opaa188"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,10]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opaa188","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,10]]}}}