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Published on: March 7, 2011
Percutaneous computed tomography-guided radiofrequency ablation of upper spinal cord pain pathways for cancer-related
1Department of Neurosurgery, Ain Shams University, Cairo, Egypt. raslana@ohsu.edu
Objective:
The author presents data to support the continued need for ablative procedures, particularly cordotomy, in the management of cancer-related pain.
Methods:
Fifty-one patients with cancer-related body or face pain were treated with computed tomography-guided radiofrequency ablation of the spinothalamic tract or trigeminal tract nucleus in the upper cervical region of the spinal cord. Forty-one patients underwent a unilateral cervical cordotomy, and 10 patients underwent a trigeminal tractotomy-nucleotomy. Three methods to assess patient pain were used: degree of pain relief, Visual Analog Scale, and total sleeping hours. The Karnofsky scale was used to measure the patient's level of function pre- and postprocedure.
Results:
After surgical intervention, patients reported initial and 6-months follow-up pain relief as 98 and 80%, respectively.
Conclusion:
Computed tomography-guided ablation of the upper cervical spinal cord is a safe and effective procedure to treat cancer pain involving the body or face. There remains a need for ablative procedures, in particular cordotomy, in the management of cancer-related pain.