CT-Guided High-Level Percutaneous Cervical Cordotomy for Intractable Cancer Pain
AIM: To evaluate the safety and effectiveness of computed tomography-guided high-level percutaneous selective cervical
cordotomy (CT-guided HPSCC).
MATERIAL and 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
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 6th 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.
CONCLUSION: 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.