NEUROSURGICAL INTERVENTIONS FOR THE MANAGEMENT OF NEUROPATHIC PAIN: A REVIEW OF CURRENT EVIDENCE

• DOI: 10.22533/at.ed.15934523270610

• Palavras-chave: Pain Surgery, Neuromodulation, Neuropathic Pain, Neurosurgical Treatment.

• Keywords: Pain Surgery, Neuromodulation, Neuropathic Pain, Neurosurgical Treatment.

• Abstract:

  Objective: To analyze and describe available neurosurgical interventions for the management of neuropathic pain, evaluating the efficacy, safety, indications, risks and benefits of different neurosurgical approaches, with a focus on neuromodulation techniques and other neuroablative procedures. Methodology: Narrative bibliographic review between April and May 2023, using the PubMed Central (PMC) database through pre-selected descriptors in different combinations. After applying inclusion and exclusion criteria, 16 studies were selected for analysis. Results: Neuropathic pain presents a challenge in its management, often being refractory to available therapeutic interventions, affecting 10% of the global population, highlighting the importance of an accurate assessment for choosing therapies with better prognosis for patients. Surgical therapy, reserved for refractory cases, is divided into ablative procedures and neuromodulation. Ablative surgery seeks permanent inactivation of pain pathways or nerve roots, including procedures such as thalamotomy, neurotomy, cordotomy, rhizotomy, among others. Final Considerations: Neuromodulation has stood out as a relevant approach in the surgical arsenal for chronic pain, offering reversible and testable methods, including pharmacological or electrical approaches, through invasive or non-invasive techniques.