O-Arm-Guided Percutaneous Radiofrequency Cordotomy

Area of Science:

• Neurosurgery
• Pain Management
• Oncology

Background:

• Advanced cancer pain is debilitating and often refractory to medical treatment.
• Selective percutaneous cordotomy offers a solution by targeting pain fibers in the spinothalamic tract.
• This procedure is beneficial for localized malignancy-related pain.

Purpose of the Study:

• To evaluate the safety and efficacy of percutaneous radiofrequency cordotomy using the O-Arm intraoperative imaging system.
• To detail technical nuances and potential complications associated with this technique.
• To assess long-term pain relief and outcomes in patients with intractable oncological pain.

Main Methods:

• Retrospective analysis of patients undergoing percutaneous cordotomy between March 2016 and March 2017.
• Utilized O-Arm imaging for 2D fluoroscopy and 3D CT reconstruction during procedures.
• Included 19 patients, with 17 completing the cordotomy procedure.

Main Results:

• Excellent immediate pain relief (94%) in completed procedures.
• Sustained pain relief at 1 month (88%) and 3 months (100% of follow-up patients).
• Mild mirror pain in 35% of patients; one serious complication (6%) of ipsilateral hemiparesis.

Conclusions:

• Percutaneous cordotomy with O-Arm imaging is a safe and effective treatment for intractable oncological pain.
• The O-Arm system facilitates precise targeting and monitoring during the procedure.
• This technique offers significant benefits for patients suffering from refractory cancer pain.