Cordotomy is a surgical procedure that interrupts the pain-conducting tracts of the spinal cord to relieve severe, otherwise intractable pain, most often in patients with advanced cancer. It was first performed in 1912 by American neurosurgeons William Gibson Spiller and Edward Martin, and it became more practical for wider use after a percutaneous version of the technique was developed in 1965. Cordotomy is effective for pain control but carries significant side effects, including abnormal sensations in the affected area and, when performed on both sides, a risk of sleep apnea.
Facts
FAQs
Why is cordotomy performed less often than it once was?
Opioids and newer interventional pain treatments reduced the need for it.
Cordotomy was first described in 1912. Since then the broader adoption of opioids, and later interventional pain procedures such as implantable pumps and spinal cord stimulators, have diminished the need for spinal cord ablation in the management of intractable pain. A review in Pain Physician describes it as still a viable option for a subset of patients, especially those with a limited life expectancy whose severe, unilateral pain is unresponsive to analgesic medications. This entry records what was held in the sources and is not medical advice.
What complications can follow a cordotomy?
New pain on the opposite side and sleep apnea after bilateral high cervical procedures are reported risks.
The same review reports a pernicious complication in 6% to 70% of patients who undergo cordotomy for unilateral pain: new pain that most often mirrors the initial pain, in the same location on the opposite side. A bilateral high cervical cordotomy carries the risk of Ondine's curse, also known as sleep-associated apnea or central hypoventilation syndrome. For patients whose lung function is compromised, one percutaneous CT-guided approach at the fourth and fifth, or fifth and sixth, cervical levels was described to avoid sleep apnea.
Connections
Treats
Source Cordotomy (Wikipedia)
Sources
1. Wikipedia
Wikipedia contributors, Wikimedia Foundation
2. Cordotomy (Wikipedia)
- First performed in 1912 by American neurosurgeons Spiller and Martin, History section
https://en.wikipedia.org/wiki/Cordotomy, lead section
Cordotomy (or chordotomy) is a surgical procedure that disables selected pain-conducting tracts in the spinal cord, in order to achieve loss of pain and temperature perception.
Treats: Pain, Lead: treats Pain
Anterolateral cordotomy is effective for relieving unilateral, somatic pain while bilateral cordotomies may be required for visceral or bilateral pain.
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