CT-guided pain procedures for intractable pain in malignancy

CT-guided stereotactic percutaneous destructive procedures, i.e. percutaneous cordotomy, trigeminal tractotomy, and extralemniscal myelotomy, have been routinely used for the treatment of localized intractable pain in malignancy since 1987. In 67 cases if local pain due to malignancy, CT guided percutaneous cordotomy was performed and in 97% complete pain control was achieved. In 45 of these cases, a "selective cordotomy" was performed meaning that analgesia was produced only in the painful region of the body. CT guided trigeminal tractotomy was applied to a total of 19 cases in 5 of which pain had been caused by malignancy. The results were satisfactory. 12 cases, suffering from visceral pain due to malignancy, were treated by CT-guided extralemniscal myelotomy and in 10 cases pain relief was achieved.