CT-Guided High-Level Percutaneous Cervical Cordotomy for Intractable Cancer Pain.
OBJECTIVE
To evaluate the safety and effectiveness of computed tomography-guided high-level percutaneous selective cervical cordotomy (CT-guided HPSCC).


METHODS
CT-guided percutaneous procedures were performed in fifty-nine patients between the years 2004- 2013 for cancer pain. Forty-eight patients with cancer-related body pain were treated with CT-guided HPSCC was evaluated retrospectively.


RESULTS
CT-guided HPSCC was performed in 33 male and 15 female patients. The mean age was 49.93 years. The distance between skin-dura, anteroposterior diameter and mediolateral diameter was measured as 40 to 71.1 mm, 8 to 88 mm and 8 to 99 mm respectively. The mean postoperative Karnofsky Performance Score (KPS) was 95. Mean preoperative Visual Analog Scale (VAS) score was 9.6, and 3.6 on postoperative day 1. The 6 < sup > th < /sup > month follow-up VAS score was 6.8. Preoperative total sleeping hours in a 24-hour period were 5.5 hours, which increased in the immediate postoperative period to 8.5 hours. The most common pathology treated was bronchogenic carcinoma. Six of the procedures were bilateral and there were no permanent complication due to the procedure.


CONCLUSIONS
CT-guided HPSCC is still very effective, cheap and repetitive procedure for cancer pain. The procedure should be performed by experienced surgeons and although there is a hegemony of opioids, the number of surgeons that perform the procedure must be increased.
Uludag University, School of Medicine, Department of Neurosurgery, Bursa, Turkey.
Ahmet
A
Bekar
M Ozgur
MO
Taskapilioğlu
Pinar
P
Eser
Hulya
H
Bilgin
D000328:Adult; D000368:Aged; D000072716:Cancer Pain / Q000601:surgery*; D066193:Cervical Cord / Q000601:surgery*; D002818:Cordotomy / Q000379:methods*; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000379:methods*; D010148:Intractable Pain / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome