Some authors stress the value of this operation (Houdart, 1956), others express reservations (Wertheimer, 1956). One factor is that some patients continue to complain of dull pain in the same area post-operatively, but this sensation is due to a removal of all sensory information, except for pain and burning. Even if this latter group is not numerous, it makes the decision difficult. Some failures, with incomplete suppression of pain, have been explained by an anterior cord pathway for the sensory fibres, which retain their function after section of the posterior roots. Some surgeons even section the anterior roots. This is unjustified, because careful observation during . operation has demonstrated that an anterior pathway for such tracts cannot be demonstrated (White and Sweet).
We ourselves have performed 167 radicotomies up to the 31st of July, 1958. We were fortunate not to meet with postoperative burning pain. We were completely satisfied with the results of procedures for arachnoiditic pain, where the pain was relieved in all cases. However, the results were less favourable with intervertebral discopathy, where the pain should be located directly at the root. Pastorova, Kuchar and Teska from our department (1952) have reported that of 118 patients operated upon for lumboischialgic syndrome, most of whom had an associated intervertebral discopathy, two continued to have pain after rhizotomy. Complete failure has been met with in tabes, disseminated sclerosis and post-herpetic pain, where these procedures are not justified. Patients with inoperable neoplasm of the appendix and uterus were satisfied with the results of this operation, less so those with a new growth of the urinary bladder. For these reasons patients must be very carefully selected, and the appropriate roots must be very carefully determined.
The operation itself is not very severe for the patient and is well tolerated.