Percutaneous cervical cordotomy and the injection of the pituitary with alcohol

The two techniques of percutaneous cordotomy and pituitary injection of alcohol have been considered as methods applicable to the relief of intractable pain in inoperatable cancer. Percutaneous cordotomy is best indicated for unilateral pain below the C5 dermatome and will produce absolute relief of pain until death in up to 90% of patients. The injection of alcohol into the pituitary gives some relief of bilateral pain in about 70% of patients. Twenty percent obtain complete freedom from pain for up to 4 months, and 20% have complete freedom from pain for over 4 months. Both methods require the use of an image intensifier X-ray machine and care in observing safety precautions is necessary for both techniques. The pituitary injection of alcohol is the simpler of the two techniques. It can relieve bilateral cancer pain and it may be used to relieve pain in the head and neck of cancer sufferers which cannot be relieved by other methods.