Percutaneous computed tomography-guided radiofrequency ablation of upper spinal cord pain pathways for cancer-related pain.
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.


CONCLUSIONS
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.
Raslan
Ahmed M
AM
Department of Neurosurgery, Ain Shams University, Cairo, Egypt. raslana@ohsu.edu
D000293:Adolescent; D000328:Adult; D000344:Afferent Pathways / Q000000981:diagnostic imaging / Q000601:surgery; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D011859:Radiography; D013126:Spinal Nerve Roots / Q000000981:diagnostic imaging* / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome