Percutaneous cervical cordotomy for cancer-related pain

Abstract The anatomic rationale of cordotomy involves interruption of pain fibres in the spinothalamic tract. Cordotomy is indicated in cancer patients with limited life expectancy who have severe, unilateral pain. The goal in patients with limited life expectancy should be to improve the quality of survival, which includes improving the patient's ability to interact with others, and to reduce the amount of time spent in contact with healthcare providers. Analgesic optimization alone may fail to adequately control cancer related pain. When successful, percutaneous cervical cordotomy allows significant reduction in pain medications, and reduces the need for clinic visits. Percutaneous procedures are preferred over open procedures for their lower morbidity. The percutaneous cervical cordotomy procedure is technically not simple and requires considerable skills of the physician performing the procedure.