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Percutaneous and open anterolateral cordotomy for intractable cancer pain: a technical note.
Neurochirurgie
November 2024
Department of Neurosurgery, University Hospital of Saint-Etienne, France; NEUROPAIN Lab, INSERM U1028, University Jean Monnet, Saint-Etienne, France.
Article Synopsis
- Anterolateral cordotomy (AL-C) is a procedure used to relieve severe cancer pain, but its usage has declined, risking the loss of expertise among neurosurgeons.
- The study reviews patient selection, outcomes, and current techniques for both percutaneous and open AL-C, supported by case examples and visuals.
- AL-C effectively reduces pain and decreases reliance on pain medications, although it may sometimes fail to provide long-lasting relief or can lead to mirror pain.
Minimally Invasive Anterolateral Cervical Cordotomy for Intractable Cancer Pain Using Microtubular Retractors: A Single Institution Case Series.
Oper Neurosurg (Hagerstown)
August 2024
Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel.
Background And Objectives: As advancements in cancer treatments have allowed patients with a high burden of disease to live longer, the number of patients who present with debilitating refractory pain has increased. Anterolateral cordotomy has long been used for the treatment of intractable unilateral cancer pain using either an imaging-guided percutaneous approach or an open surgical approach. In this report, we describe a novel minimally invasive modification to the open surgical approach.
View Article and Find Full Text PDFOpen thoracic cordotomy for intractable cancer pain: a how I do it.
Acta Neurochir (Wien)
August 2023
Department of Neurosurgery, Service de Neurochirurgie, CHU de Caen, Avenue de La Côte de Nacre, 14000, Caen, France.
Background: Some cancers of the lower extremity involve nerves and plexuses and can produce extreme drug-resistant noceptive pain. In these cases, open thoracic cordotomy can be proposed.
Method: This procedure involves disruption of the spinothalamic tract, which sustains nociceptive pathways.
History of Spinal Cord "Pain" Pathways Including the Pathways Not Taken.
Front Pain Res (Lausanne)
June 2022
Department of Anatomy, University of California San Francisco, San Francisco, CA, United States.
Traditional medical neuroanatomy/neurobiology textbooks teach that pain is generated by several ascending pathways that course in the anterolateral quadrant of the spinal cord, including the spinothalamic, spinoreticular and spinoparabrachial tracts. The textbooks also teach, building upon the mid-19th century report of Brown-Séquard, that unilateral cordotomy, namely section of the anterolateral quadrant, leads to contralateral loss of pain (and temperature). In many respects, however, this simple relationship has not held up.
View Article and Find Full Text PDFCordotomy for Intractable Cancer Pain: A Narrative Review.
Pain Physician
June 2020
University of Texas, MD Anderson Cancer Center, Houston, TX.
Background: Cordotomy is an invasive procedure for the management of intractable pain not controlled by conventional therapies, such as analgesics or nerve block. This procedure involves mechanical disruption of nociceptive pathways in the anterolateral column, specifically the spinothalamic and spinoreticular pathways to relieve pain while preserving fine touch and proprioceptive tracts.
Objectives: The purpose of this review article is to refresh our knowledge of cordotomy and support its continued use in managing intractable pain due to malignant disease.
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