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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2021; 40(01): 071-077
DOI: 10.1055/s-0040-1718425
Review Article | Artigo de Revisão

Cervical Cordotomy in Terminal Cancer: Pain Relieving in Oncological Treatment

Cordotomia cervical em câncer terminal: Alívio da dor em tratamento oncológico
Maria Clara Cardoso Seba 
1   Faculdade de Medicina do ABC, Santo André, SP, Brazil
,
Henrique Nicola Santo Antonio Bernardo 
1   Faculdade de Medicina do ABC, Santo André, SP, Brazil
,
Natally Marques Santiago Sarturi 
2   Divison of Neurosurgery, Hospital Santa Paula, São Paulo, SP, Brazil
,
Thania Gonzalez Rossi 
2   Divison of Neurosurgery, Hospital Santa Paula, São Paulo, SP, Brazil
,
Newton Maciel de Oliveira 
3   Department of Histology, Pontifícia Universidade Católica de São Paulo, Sorocaba, SP, Brazil
,
Paulo Henrique Pires de Aguiar 
1   Faculdade de Medicina do ABC, Santo André, SP, Brazil
2   Divison of Neurosurgery, Hospital Santa Paula, São Paulo, SP, Brazil
4   Pontifícia Universidade Católica de São Paulo, Sorocaba, Brazil
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Abstract

Cordotomy consists in the discontinuation of the lateral spinothalamic tract (LST) in the anterolateral quadrant of the spinal cord, which aims to reduce the transference of nociceptive information in the dorsal horn of the gray matter of the spinal cord to the somatosensory cortex. The main indication is for patients with terminal cancer that have a low life expectancy. It improves the quality of life by relieving pain. The results are promising and the pain relief rate varies between 69 and 100%. Generally speaking, the complications are mostly temporary and not remarkable.

Resumo

A cordotomia consiste na descontinuação do trato espinotalâmico lateral (LST, na sigla em inglês) no quadrante anterolateral da medula espinhal, que visa reduzir a transferência de informações nociceptivas no corno dorsal da substância cinzenta da medula espinhal para o córtex somatossensorial. A principal indicação é para pacientes com câncer terminal com baixa expectativa de vida. Esse procedimento melhora a qualidade de vida, aliviando a dor. Os resultados são promissores e a taxa de alívio da dor varia entre 69 e 100%. De um modo geral, as complicações são principalmente temporárias e não são notáveis.

Keywords

cordotomy - intractable pain - neoplasms - spinothalamic tracts

Palavras-chave

cordotomia - dor intratável - neoplasias - tratos espinotalâmicos

Note

Work developed at: Faculdade de Medicina do ABC (FMABC).




Publication History

Received: 15 April 2020

Accepted: 05 August 2020

Article published online:
26 November 2020

© 2020. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Hyndman OR. Possibility of differential section of the spinothalamic tract: a clinical and histologic study. Arch Surg 1939; 38 (06) 1036
    CrossrefPubMedGoogle Scholar
  • 2 Kanpolat Y, Akyar S, Cağlar S. Diametral measurements of the upper spinal cord for stereotactic pain procedures: experimental and clinical study. Surg Neurol 1995; 43 (05) 478-482 , discussion 482–483
    CrossrefPubMedGoogle Scholar
  • 3 Lorenz R. Methods of Percutaneous Spino-Thalamic Tract Section. In: Krayenbühl H, Brihaye J, Loew F, Logue V, Mingrino S, Pertuiset B. et al., editors. Advances and Technical Standards in Neurosurgery [Internet]. Vienna: Springer Vienna; 1976: 123-45 . Available at: https://doi.org/10.1007/978-3-7091-7080-9_6
    CrossrefGoogle Scholar
  • 4 Taren JA, Davis R, Crosby EC. Target physiologic corroboration in stereotaxic cervical cordotomy. J Neurosurg 1969; 30 (05) 569-584
    CrossrefPubMedGoogle Scholar
  • 5 Walker AE. The spinothalamic tract in man. Arch Neurol Psychiatry 1940; 43 (02) 284-298
    CrossrefPubMedGoogle Scholar
  • 6 White JC, Sweet WH. Pain and the neurosurgeon; a forty-year experience, Springfield, Ill.: C.C. Thomas. 1969
    Google Scholar
  • 7 Sindou M, Jeanmonod D, Mertens P. Ablative neurosurgical procedures for the treatment of chronic pain. Neurophysiol Clin 1990; 20 (05) 399-423
    CrossrefPubMedGoogle Scholar
  • 8 Kanpolat Y, Caglar S, Akyar S, Temiz C. CT-Guided Pain Procedures for Intractable Pain in Malignancy. In: Meyerson BA, Ostertag C. editors. Advances in Stereotactic and Functional Neurosurgery 11. Vienna: Springer Vienna; 1995: 88-91
    Google Scholar
  • 9 Fonoff ET, Lopez WOC, de Oliveira YSA, Teixeira MJ. Microendoscopy-guided percutaneous cordotomy for intractable pain: case series of 24 patients. J Neurosurg 2016; 124 (02) 389-396
    CrossrefPubMedGoogle Scholar
  • 10 Clarke E, O'Malley CD. Function of the spinal Cord. In: Clarke E, O'Malley CD. editors. The human brain and spinal cord. San Francisco: Norman Publishing; 1996: 291-322
    Google Scholar
  • 11 Fonoff ET, de Oliveira YSA, Lopez WOC, Alho EJL, Lara NA, Teixeira MJ. Endoscopic-guided percutaneous radiofrequency cordotomy. J Neurosurg 2010; 113 (03) 524-527
    CrossrefPubMedGoogle Scholar
  • 12 Kanpolat Y, Deda H, Akyar S, Bilgiç S. CT-guided Percutaneous Cordotomy. In: Broggi G, Burzaco J, Hitchcock ER, Meyerson BA, Tóth S. editors. Advances in Stereotactic and Functional Neurosurgery 8. Vienna: Springer Vienna; 1989: 67-8
    Google Scholar
  • 13 Kanpolat Y, Akyar S, Cağlar S, Unlü A, Bilgiç S. CT-guided percutaneous selective cordotomy. Acta Neurochir (Wien) 1993; 123 (1-2): 92-96
    CrossrefPubMedGoogle Scholar
  • 14 Kanpolat Y, Savas A, Çaglar S, Temiz C, Akyar S. Computerized tomography-guided percutaneous bilateral selective cordotomy. Neurosurg Focus 1997; 2 (01) e4
    PubMedGoogle Scholar
  • 15 Kanpolat Y. Cordotomy for pain. In Handbook of stereotactic and functional neurosurgery. Schulder (ed) Marcel & Dekker. New York: Basel; 2003: 459-472
    Google Scholar
  • 16 Lin PM, Gildenberg PL, Polakoff PP. An anterior approach to percutaneous lower cervical cordotomy. J Neurosurg 1966; 25 (05) 553-560
    CrossrefPubMedGoogle Scholar
  • 17 Mullan S, Harper PV, Hekmatpanah J, Torres H, Dobbin G. Percutaneous Interruption of Spinal-Pain Tracts by Means of a Strontium 90 Needle. J Neurosurg 1963; 20 (11) 931-939
    CrossrefPubMedGoogle Scholar
  • 18 Mullan S, Hekmatpanah J, Dobben G, Beckman F. Percutaneous, intramedullary cordotomy utilizing the unipolar anodal electrolytic lesion. J Neurosurg 1965; 22 (06) 548-553
    CrossrefPubMedGoogle Scholar
  • 19 Rosomoff HL, Brown CJ, Sheptak P. Percutaneous radiofrequency cervical cordotomy: technique. J Neurosurg 1965; 23 (06) 639-644
    CrossrefPubMedGoogle Scholar
  • 20 Schüller A. Über operative Durchtrennung der Rückenmarksstrange (Chordotomie). Wien Med Woch 1910; 60: 2292-2295
    PubMedGoogle Scholar
  • 21 Spiller WG. The location within spinal cord of the fibers of temperature and pain sensations. J Nerv Ment Dis 1905; 32: 318-320
    CrossrefPubMedGoogle Scholar
  • 22 Spiller WG, Martin E. The treatment of persistent pain of organic origin in the lower part of body by division of the anterolateral column of spinal cord. JAMA 1912; 58: 1489-1490
    CrossrefPubMedGoogle Scholar
  • 23 Teixeira MJ. Various functional procedures for pain. In: Gildenberg PL, Tasker RR. (eds) Textbook of stereotatic and functional neurosurgery, Part II, facial pain. New York: The Mac Graw Hill Companies Inc; 1389-1402
    Google Scholar
  • 24 Rosen S. chapter 174 - Percutaneous Cordotomy. In: Waldman SD, Bloch JI. editors. Pain Management [Internet]. Philadelphia: W.B. Saunders; 2007: 1501-17 . Available at: http://www.sciencedirect.com/science/article/pii/B9780721603346501783
    Google Scholar
  • 25 Patt RE. 15 - Neurosurgical Intervention for Chronic Pain Problems. In: FROST EAM. editor. Clinical Anesthesia in Neurosurgery [Internet]. Butterworth-Heinemann. 1991: 347-81 . Available at: http://www.sciencedirect.com/science/article/pii/B9780409901719500210
    Google Scholar
  • 26 Silvers JE, Campbell JN, Argoff CE. Chapter 42 - Neurostimulatory and Neuroablative Procedures. In: Argoff CE, McCleane G. editors. Pain Management Secrets (Third Edition) [Internet]. Third Edition. Philadelphia: Mosby; 2009: 323-7 . Available at: http://www.sciencedirect.com/science/article/pii/B9780323040198000421
    Google Scholar
  • 27 Cherny NI. Chapter 43 - The management of cancer pain. In: Melzack R, Wall PD. editors. Handbook of Pain Management [Internet]. Philadelphia: Churchill Livingstone; 2003: 641-66 . Available at: http://www.sciencedirect.com/science/article/pii/B9780443072017500473
    Google Scholar
  • 28 Sather MD, Follett KA. Chapter 19 - Neurosurgical Management of Pain. In: Benzon HT, Rathmell JP, Wu CL, Turk DC, Argoff CE. editors. Raj's Practical Management of Pain (Fourth Edition) [Internet]. Fourth Edition. Philadelphia: Mosby; 2008: 401-11 . Available at: http://www.sciencedirect.com/science/article/pii/B9780323041843500224
    Google Scholar
  • 29 Jackson MB, Pounder D, Price C, Matthews AW, Neville E. Percutaneous cervical cordotomy for the control of pain in patients with pleural mesothelioma. Thorax 1999; 54 (03) 238-241
    CrossrefPubMedGoogle Scholar
  • 30 Steel D, Kirkman MA, Thompson DNP, Aquilina K. Open thoracic anterolateral cordotomy for pain relief in children: report of 2 cases. J Neurosurg Pediatr 2017; 20 (03) 278-283
    CrossrefPubMedGoogle Scholar
  • 31 Bain E, Hugel H, Sharma M. Percutaneous cervical cordotomy for the management of pain from cancer: a prospective review of 45 cases. J Palliat Med 2013; 16 (08) 901-907
    CrossrefPubMedGoogle Scholar
  • 32 Lewin J, Hugel H, Sharma ML. Percutaneous cervical cordotomy for non-cancer pain in a patient with terminal esophageal carcinoma. J Pain Symptom Manage 2012; 43 (03) e8-e9
    CrossrefPubMedGoogle Scholar
  • 33 Honey CR, Yeomans W, Isaacs A, Honey CM. The dying art of percutaneous cordotomy in Canada. J Palliat Med 2014; 17 (05) 624-628
    CrossrefPubMedGoogle Scholar
  • 34 Crul BJP, Blok LM, van Egmond J, van Dongen RTM. The present role of percutaneous cervical cordotomy for the treatment of cancer pain. J Headache Pain 2005; 6 (01) 24-29
    CrossrefPubMedGoogle Scholar
  • 35 Kanpolat Y, Ugur HC, Ayten M, Elhan AH. Computed Tomography-guided Percutaneous Cordotomy for Intractable Pain in Malignancy. Operative Neurosurgery. 2009 Mar 1;64(suppl_1):ONS187–94.
    PubMedGoogle Scholar
  • 36 Sanders M, Zuurmond W. Safety of unilateral and bilateral percutaneous cervical cordotomy in 80 terminally ill cancer patients. J Clin Oncol 1995; 13 (06) 1509-1512
    CrossrefPubMedGoogle Scholar
  • 37 Kanpolat Y. Neurosurgical Management of Cancer Pain. In: Sindou M. editor. Practical Handbook of Neurosurgery [Internet]. Vienna: Springer Vienna; 2009. [cited 2020 Apr 7]. p. 1388–407. Available at: http://link.springer.com/10.1007/978-3-211-84820-3_82
    CrossrefGoogle Scholar
  • 38 Tasker RR, North R. Cordotomy and Myelotomy. In: North RB, Levy RM. editors. Neurosurgical Management of Pain [Internet]. New York, NY: Springer New York; 1997: 191-220 . Available at: https://doi.org/10.1007/978-1-4612-1938-5_15
    CrossrefGoogle Scholar
  • 39 Gybels JM. Indications for use of neurosurgical techniques in pain control. In: Bond MR, Charlton JE, Wolf J. editors. Proceedings of the Sixt world Congress on Pain. Amsterdam: Elsevier; 475
    Google Scholar
  • 40 Osenbach RK, Burchiel KJ. Percutaneous cordotomy. In: Kaye A, Black P. (eds) Operative Neurosurgery, chapter 128. Philadelphia: ChurchillLivingstone; 1569-1579
    Google Scholar
  • 41 Raslan AM. Percutaneous Computed Tomography-guided Radiofrequency Ablation of Upper Spinal Cord Pain Pathways for Cancer-Related Pain. Operative Neurosurgery. 2008 Mar 1;62(suppl_1):ONS226–34.
    PubMedGoogle Scholar
  • 42 Kanpolat Y. Percutaneous stereotactic pain procedures: percutaneous cordotomy, extralemniscal myelotomy, trigeminal tractotomy-nucleotomy. In: Surgical Management of pain, Burchiel K and editors. Stuttgart: Thieme; 2002: 745-762
    Google Scholar
  • 43 Kanpolat Y. Percutaneous destructive pain procedures on the upper spinal cord and brain stem in cancer pain: CT-guided techniques, indications and results. In: Pickard JD, Akalan N, Di Rocco C, Dolenc VV, Antunes JL, Mooij JJA. et al., editors. Advances and Technical Standards in Neurosurgery [Internet]. Vienna: Springer Vienna; 2007: 147-73 . Available at: https://doi.org/10.1007/978-3-211-47423-5_6
    CrossrefGoogle Scholar
  • 44 Syed ON, Komotar RJ, Winfree C. Cordotomy. In: Connolly S, Mc Khann GM, Huang J, Choudhri TF, Komotar RJ, Mocco J. (eds). Fundamentals of Operative Techniques in Neurosurgery. New York: Thieme; 2010: 635-638
    Google Scholar
  • 45 Lahuerta J, Lipton S, Wells JC. Percutaneous cervical cordotomy: results and complications in a recent series of 100 patients. Ann R Coll Surg Engl 1985; 67 (01) 41-44
    PubMedGoogle Scholar