Percutaneous computed tomography-guided transdiscal low cervical cordotomy for cancer pain as a method to avoid sleep apnea.
OBJECTIVE
Study of percutaneous computed tomography (CT)-guided transdiscal low cervical cordotomy undertaken to treat pain in cancer patients.


METHODS
At the Department of Neurosurgery, Ain Shams University, Cairo, Egypt, 8 cancer pain patients, with either impaired pulmonary function or a previous cordotomy on an opposite side (sleep apnea was a feared complication) that prevented the possibility of undergoing a C(1-2) cordotomy, underwent a percutaneous CT-guided transdiscal low cervical cordotomy (C(4-5) or C(5-6)) to treat cancer pain.


RESULTS
Seven patients experienced initial improvement. One patient re-experienced pain within 2 weeks and 1 patient experienced no pain relief. In 6 patients in whom the cordotomy procedure was completed, satisfactory or complete pain relief, throughout a 6-month follow-up period was reported. In contrast, in 2 patients in whom the cordotomy was not completed there was no persistent pain relief.


CONCLUSIONS
Percutaneous CT-guided cordotomy remains a successful procedure to control pain in cancer patients, and is an affordable viable option under circumstances where economic disadvantage is an overriding determinate.
Raslan
Ahmed M
AM
Department of Neurosurgery, Ain Shams University, Cairo, Egypt. raslana@ohsu.edu
D000230:Adenocarcinoma / Q000503:physiopathology / Q000556:secondary; D000328:Adult; D000368:Aged; D002404:Catheterization; D002574:Cervical Vertebrae; D002818:Cordotomy / Q000009:adverse effects / Q000379:methods*; D017097:Electric Impedance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008175:Lung Neoplasms / Q000503:physiopathology / Q000556:secondary; D008297:Male; D008654:Mesothelioma / Q000503:physiopathology; D008875:Middle Aged; D009101:Multiple Myeloma / Q000503:physiopathology; D009369:Neoplasms / Q000503:physiopathology*; D010148:Intractable Pain / Q000209:etiology / Q000601:surgery*; D010166:Palliative Care; D010997:Pleural Neoplasms / Q000503:physiopathology; D015641:Radiography, Interventional; D012086:Reoperation; D012891:Sleep Apnea Syndromes / Q000209:etiology / Q000517:prevention & control*; D013133:Spinothalamic Tracts / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome