Pain Disorders

The UCSF Department of Neurological Surgery is home to one of the most comprehensive pain surgery programs in the nation. Neurosurgeons specializing in complex regional pain syndromes, failed back surgery syndrome, facial pain, and other pain disorders that do not respond to medication work with a multidisciplinary team to employ surgical strategies for managing severe pain.

Chronic Pain

Our pain specialists use the most current neuromodulation therapies, including 32-contact surgically implanted leads to optimize back pain coverage in patients with failed back surgery syndrome, rechargeable pulse generators for complex pain requiring more sophisticated programming, high-frequency therapy, tonic and burst therapy, high-density waveform therapy, dorsal root ganglion stimulation therapy and peripheral nerve stimulation therapy.

They are also experienced with neurolysis, rhizotomy and DREZ (dorsal root entry zone) procedures. This group also offers a comprehensive intrathecal drug-delivery program to treat patients with refractory nociceptive pain, as well as movement disorders and spinal cord injury. In addition, our surgical team includes experienced electrophysiologists who perform intraoperative nerve function monitoring to prevent damage to functional nerve fibers. We use state-of-the-art diagnostic imaging modalities, including diffusion tensor tractography and spectroscopy, 3 Tesla (3T) MRI, ultrasound and MR neurography.

Cranial Nerve Disorders and Facial Pain

For trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia, we provide the most advanced surgical treatment options at a high-volume referral center, having treated more than 1,800 patients over 45 years. All patients undergo detailed clinical evaluation as well as high-resolution MRI and MR angiographic imaging. To ensure safety, we also use state-of-the art intraoperative electrophysiology for cranial nerve monitoring. Microvascular decompression, radiosurgery and percutaneous rhizotomy are the most common surgical treatments. We also specialize in care for patients with non-neuropathic pain and atypical pain syndromes and work closely with the UCSF Center for Orofacial Pain and the UCSF Headache Center.

Research

There is a strong focus on outcomes research for pain surgery strategies, as well as clinical trials for new therapies. UCSF is currently participating in a trial of deep brain stimulation for chronic neuropathic pain that aims to treat post-stroke pain syndrome, phantom limb pain, and spinal cord injury pain.

 

Faculty

Adult Neurological Surgery

Line Jacques, MD
Edward Chang, MD

Nursing

Mariann Ward
Liz Gibson, NP

 

Contact

Pain Disorders Program

Department of Neurological Surgery
400 Parnassus Ave, 8th Floor
San Francisco, CA 94143
tel (415) 353-7500