Percutaneous computed tomography-guided radiofrequency ablation of upper spinal cord pain pathways for cancer-related pain

Neurosurgery. 2008 Mar;62(3 Suppl 1):226-33; discussion 233-4. doi: 10.1227/01.neu.0000317397.16089.f5.


Objective: The author presents data to support the continued need for ablative procedures, particularly cordotomy, in the management of cancer-related pain.

Methods: Fifty-one patients with cancer-related body or face pain were treated with computed tomography-guided radiofrequency ablation of the spinothalamic tract or trigeminal tract nucleus in the upper cervical region of the spinal cord. Forty-one patients underwent a unilateral cervical cordotomy, and 10 patients underwent a trigeminal tractotomy-nucleotomy. Three methods to assess patient pain were used: degree of pain relief, Visual Analog Scale, and total sleeping hours. The Karnofsky scale was used to measure the patient's level of function pre- and postprocedure.

Results: After surgical intervention, patients reported initial and 6-months follow-up pain relief as 98 and 80%, respectively.

Conclusion: Computed tomography-guided ablation of the upper cervical spinal cord is a safe and effective procedure to treat cancer pain involving the body or face. There remains a need for ablative procedures, in particular cordotomy, in the management of cancer-related pain.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Afferent Pathways / diagnostic imaging
  • Afferent Pathways / surgery
  • Aged
  • Catheter Ablation / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / diagnostic imaging*
  • Neoplasms / surgery*
  • Neurosurgical Procedures / methods
  • Pain / etiology
  • Pain / prevention & control*
  • Radiography
  • Spinal Nerve Roots / diagnostic imaging*
  • Spinal Nerve Roots / surgery*
  • Surgery, Computer-Assisted / methods*
  • Treatment Outcome