Palliative CT-Guided Cordotomy for Medically Intractable Pain in Patients with Cancer.
Palliative cervical cordotomy can be performed via percutaneous radiofrequency ablation of the lateral C1-2 spinothalamic tract. This rare procedure can be safe, effective, and advantageous in mitigating medically intractable unilateral extremity pain for selected patients with end-stage cancer. This report reviews the indications, techniques, risks, and potential benefits of cordotomy. We describe our recent experience treating 3 patients with CT-guided C1-2 cordotomy and provide the first characterization of spinal cord diffusion MR imaging changes associated with successful cordotomy.
From the Department of Radiology (T.M.S., M.J.H., B.A.C., M.T.B., E.F.) timothy.shepherd@nyumc.org.|Center for Advanced Imaging Innovation and Research (T.M.S., E.F.).
T M
0000-0003-0232-1636
TM
Shepherd
From the Department of Radiology (T.M.S., M.J.H., B.A.C., M.T.B., E.F.).
M J
0000-0002-3435-4662
MJ
Hoch
From the Department of Radiology (T.M.S., M.J.H., B.A.C., M.T.B., E.F.).
B A
0000-0003-1470-4175
BA
Cohen
From the Department of Radiology (T.M.S., M.J.H., B.A.C., M.T.B., E.F.).
M T
0000-0003-1625-0293
MT
Bruno
From the Department of Radiology (T.M.S., M.J.H., B.A.C., M.T.B., E.F.).|Center for Advanced Imaging Innovation and Research (T.M.S., E.F.).
E
0000-0002-1384-8591
E
Fieremans
Departments of Medicine (G.R.).
G
0000-0002-0337-5399
G
Rosen
Neurosurgery (D.P., A.Y.M.), New York University, New York, New York.
D
0000-0002-0731-442X
D
Pacione
Neurosurgery (D.P., A.Y.M.), New York University, New York, New York.
A Y
0000-0003-1493-0463
AY
Mogilner
D001859:Bone Neoplasms / Q000150:complications; D000072716:Cancer Pain / Q000601:surgery*; D017115:Catheter Ablation; D002818:Cordotomy / Q000379:methods*; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000150:complications; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000150:complications; D010148:Intractable Pain / Q000601:surgery*; D010166:Palliative Care / Q000379:methods*; D010386:Pelvic Neoplasms / Q000150:complications; D015641:Radiography, Interventional; D013133:Spinothalamic Tracts / Q000601:surgery; D014057:Tomography, X-Ray Computed