{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T07:45:53Z","timestamp":1768290353321,"version":"3.49.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Over the past few decades, various authors have performed open or stereotactic trigeminal nucleotractotomy for the treatment of neuropathic facial pain resistant to medical treatment. Stereotactic procedures can be performed percutaneously under local anesthesia, allowing intraoperative neurological examination as a method for target refinement. However, blind percutaneous procedures in the region of the atlantooccipital transition carry a considerably high risk of vascular injuries that may bring prohibitive neurological deficit or even death. To avoid such complications, the authors present the first clinical use of microendoscopy to assist percutaneous radiofrequency trigeminal nucleotractotomy. The aim of this article is to demonstrate intradural microendoscopic visualization of the medulla oblongata through an atlantooccipital percutaneous approach.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors present a case of severe postherpetic facial neuralgia in a patient who underwent the procedure and had satisfactory results. Stereotactic computational image planning for targeting the spinal trigeminal tract and nucleus in the posterolateral medulla was performed, allowing for an accurate percutaneous approach. Immediately before radiofrequency electrode insertion, a fine endoscope was introduced to visualize the structures in the cisterna magna.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Microendoscopic visualization offered clear identification of the pial surface of the medulla oblongata and its blood vessels, the arachnoid membrane, cranial nerve rootlets and their entry zone, and larger vessels such as the vertebral arteries and the branches of the posterior inferior cerebellar artery.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The initial application of this technique suggests that percutaneous microendoscopy may be useful for particular manipulation of the medulla oblongata, increasing the safety of the procedure and likely improving its effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.8.jns11618","type":"journal-article","created":{"date-parts":[[2011,10,14]],"date-time":"2011-10-14T15:48:20Z","timestamp":1318607300000},"page":"331-335","source":"Crossref","is-referenced-by-count":8,"title":["Microendoscopic stereotactic-guided percutaneous radiofrequency trigeminal nucleotractotomy"],"prefix":"10.3171","volume":"116","author":[{"given":"Manoel Jacobsen","family":"Teixeira","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabr\u00edcio Freitas","family":"de Almeida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ywzhe Sifuentes Almeida","family":"de Oliveira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erich Talamoni","family":"Fonoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns11618","series-title":"Appl Neurophysiol","first-page":"160","article-title":"Stereotactic radiofrequency lesion making","volume":"46","author":"Cosman","year":"1983"},{"key":"b2-jns11618","series-title":"Bull Los Angeles Neurol Soc","first-page":"86","article-title":"Percutaneous trigeminal tractotomy. Case report-utilizing stereotactic radiofrequency lesion","volume":"32","author":"Crue","year":"1967"},{"key":"b3-jns11618","series-title":"Brain Res","first-page":"7","article-title":"The rostral part of the trigeminal sensory complex is involved in orofacial nociception","volume":"448","author":"Dallel","year":"1988"},{"key":"b4-jns11618","series-title":"J Neurosurg","first-page":"524","article-title":"Endoscopic-guided percutaneous radiofrequency cordotomy","volume":"113","author":"Fonoff","year":"2010"},{"key":"b5-jns11618","series-title":"Acta Neurochir Suppl (Wien)","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/978-3-211-99370-5_12","article-title":"Endoscopic approaches to the spinal cord","volume":"108","author":"Fonoff","year":"2011"},{"key":"b6-jns11618","series-title":"JAMA","first-page":"1940","article-title":"Intractable facial pain relieved by percutaneous trigeminal tractotomy","volume":"218","author":"Fox","year":"1971"},{"key":"b7-jns11618","series-title":"Acta Neurochir (Wien)","first-page":"83","article-title":"Percutaneous trigeminal tractotomy for facial pain","volume":"29","author":"Fox","year":"1973"},{"key":"b8-jns11618","series-title":"Bonica's Managements of Pain","first-page":"2023","article-title":"Neurosurgical operations on the spinal cord","author":"Garber","year":"2001"},{"key":"b9-jns11618","series-title":"Arch Surg","first-page":"171","article-title":"Trigeminal tractotomy; observations on 48 cases","volume":"57","author":"Hamby","year":"1948"},{"key":"b10-jns11618","series-title":"Ann Clin Res","first-page":"131","article-title":"Stereotactic trigeminal tractotomy","volume":"2","author":"Hitchcock","year":"1970"},{"key":"b11-jns11618","series-title":"J Neurosurg","first-page":"412","article-title":"Stereotaxic trigeminal tractotomy for post-herpetic facial pain","volume":"37","author":"Hitchcock","year":"1972"},{"key":"b12-jns11618","series-title":"Brain Res","first-page":"547","article-title":"Trigeminal nociceptive and non-nociceptive neurones: brain stem intranuclear projections and modulation by orofacial, periqueductal gray and nucleus raphe magnus stimuli","volume":"170","author":"Hu","year":"1979"},{"key":"b13-jns11618","series-title":"Acta Neurochir (Wien)","first-page":"112","article-title":"CT-guided trigeminal tractotomy","volume":"100","author":"Kanpolat","year":"1989"},{"key":"b14-jns11618","series-title":"J Neurosurg","first-page":"494","article-title":"Treatment of essential neuralgia of the 9th nerve by selective tractotomy","volume":"23","author":"Kunc","year":"1965"},{"key":"b15-jns11618","series-title":"Acta Neurochir Suppl (Wien)","first-page":"150","article-title":"Motor cortex stimulation as treatment of trigeminal neuropathic pain","volume":"58","author":"Meyerson","year":"1993"},{"key":"b16-jns11618","series-title":"J Neurol Neurosurg Psychiatry","first-page":"270","article-title":"Late results of bulbar trigeminal tractotomy. Some remarks on recovery of sensibility","volume":"34","author":"Moffie","year":"1971"},{"key":"b17-jns11618","series-title":"Surg Neurol","first-page":"151","article-title":"Eighteen-gauge microscopic-telescopic needle endoscope with electrode channel: potential clinical and research application","volume":"2","author":"Olinger","year":"1974"},{"key":"b18-jns11618","series-title":"Stereotact Funct Neurosurg","first-page":"175","article-title":"Stereotactic trigeminal nucleotomy for dysesthetic facial pain","volume":"68","author":"Piedimonte","year":"1997"},{"key":"b19-jns11618","series-title":"Acta Neurochir Suppl (Wien)","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/978-3-7091-9029-6_14","article-title":"Craniofacial postherpetic neuralgia managed by stereotactic spinal trigeminal nucleotomy","volume":"46","author":"Schvarcz","year":"1989"},{"key":"b20-jns11618","series-title":"Acta Psychiatr Scand (Suppl)","first-page":"1","article-title":"Studies on pain conduction in the trigeminal nerve: contribution to surgical treatment of facial pain","volume":"17","author":"Sj\u00f6qvist","year":"1938"},{"key":"b21-jns11618","series-title":"Trigeminal Neuralgia: Its History and Treatment","author":"Stookey","year":"1959"},{"key":"b22-jns11618","series-title":"J Neurosurg","first-page":"116","article-title":"Anatomic pathways related to pain in face and neck","volume":"19","author":"Taren","year":"1962"},{"key":"b23-jns11618","series-title":"Textbook of Stereotactic and Functional Neurosurgery","first-page":"2097","article-title":"Technique of trigeminal nucleotractotomy","volume":"1","author":"Teixeira","year":"2009"},{"key":"b24-jns11618","series-title":"Pain and the Neurosurgeon: a Forty-Year Experience","author":"White","year":"1969"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/2\/article-p331.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/2\/article-p331.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/2\/article-p331.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:37:22Z","timestamp":1679877442000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/2\/article-p331.xml"}},"subtitle":["Technical note"],"short-title":[],"issued":{"date-parts":[[2012,2]]},"references-count":24,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2011.8.jns11618","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2]]}}}