Cordotomy involves creating a lesion of the lateral spinothalamic tract, which is located in the anterolateral quadrant of the spinal cord.
It is estimated that 20% of the spinal cord must be ablated to achieve adequate pain relief with cordotomy.
Several techniques exist for performing cordotomy, including open surgical exposure and mechanical lesioning of the spinothalamic tract, and percutaneous radiofrequency techniques with use of fluoroscopy or CT. Percutaneous CT-guided cordotomy at C1–2 is currently the standard technique used.
The goal of cordotomy is to achieve diminished pinprick sensation in the painful region of the body.
Early reports indicated that the complication rate for open and percutaneous cordotomy was significant; the incidence of short-term limb weakness was high (up to 70%). However, in the era of CT-guided techniques, this complication rate has become very low (< 1%).
See reference for more information.
Adapted from Medscape News & Perspective. Cordotomy for treatment of cancer-related pain: patient selection and intervention timing. Available at http://www.medscape.com/viewarticle/812503. Accessed on May 20, 2016. To view the entire article and all other content on the Medscape News and Perspective site, a free, one-time registration is required.