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November 1947, Vol 55, No. 5 >
ARTICLE | November 1947

MEDULLARY TRACTOTOMY FOR RELIEF OF INTRACTABLE PAIN IN UPPER LEVELS

ALBERT S. CRAWFORD, M.D.
Arch Surg. 1947;55(5):523-529. doi:10.1001/archsurg.1947.01230080532002.
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MEDULLARY tractotomy has already become an established procedure as a method of severing the afferent pain pathways—the spinothalamic tracts. Several surgeons deserve mention as pioneers in developing this procedure. Schwartz and O'Leary1 reported the first case in 1941 after Sjoquist,2 Rowbottom,3 Walker4 and Grant, Groff and Lewy5 proved the method feasible from their experiences with medullary tractotomy of the descending root of the fifth cranial nerve. White6 also reported a case in 1941, pointing out that the incision should be made caudad to the lower end of the olive. Adams and Munro7 in 1944 reported 3 cases, in 1 of which a bilateral tractotomy was done in two stages, with survival in all. In his cases, however, the upper level of analgesia for pain was in the upper dorsal region. He apparently felt that it was not feasible to try for a higher

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