title: [Punctate midline myelotomy for the treatment of oncologic visceral pain: analysis of three cases].
abstract: BACKGROUND
  A new midline posterior column pathway related to visceral pain has been recently discovered.
  
  
  OBJECTIVE
  To present its interruption by a punctate midline myelotomy providing significant visceral oncologic pain relief.
  
  
  METHODS
  Three patients with abdominal cancer refractory pain from opiate analgesics were treated by a punctate midline myelotomy through thoracic laminectomy.
  
  
  RESULTS
  Complete pain control was achieved in two patients, one had no more narcotics and the other one had significant lowering of opiate intake doses. The third patient was intolerant to narcotics having 80% relieving pain. There were no postoperative neurological deficits.
  
  
  CONCLUSIONS
  The present report reaffirms the existence of a dorsal column midline pathway related to visceral pain in humans, and its interruption ameliorates abdominal pain due to cancer.
authors.affiliation: Serviço de Neurologia, Hospital Universitário Cajuru, Pontíficia Universidade Católica do Paraná, Hospital Universitário Cajuru, Av. São José 300, 80050-350 Curitiba PR, Brazil. anfrancisco@uol.com.br
authors.forename: Alexandre N
authors.initials: AN
authors.lastname: Francisco
authors.forename: Carlos A F
authors.initials: CA
authors.lastname: Lobão
authors.forename: Viviane S
authors.initials: VS
authors.lastname: Sassaki
authors.forename: Maria C P
authors.initials: MC
authors.lastname: Garbossa
authors.forename: Luiz R
authors.initials: LR
authors.lastname: Aguiar
mesh_terms: D000368:Aged; D003110:Colonic Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D010147:Pain Measurement; D010148:Intractable Pain / Q000209:etiology* / Q000601:surgery; D011677:Punctures / Q000379:methods; D013116:Spinal Cord / Q000601:surgery*; D013274:Stomach Neoplasms / Q000150:complications*; D016896:Treatment Outcome; D014781:Viscera