Computed Tomography-Guided Percutaneous Cordotomy

Microendoscopy-guided percutaneous cordotomy for intractable pain: case series of 24 patients

“…Much progress has been achieved in computed tomography-guided percutaneous cordotomy, demonstrating good results, and the use of safer contrast media. 5,15,24,33 Microendoscopy-guided procedures may be considered an evolved form of cordotomy. The present technique provides a clear detailed visualization of the spinal cord by avoiding vascular injuries and permitting the use of anatomical landmarks to guide target localization.…”

“…On the other hand, fibers from the lower trunk and limbs are located in the posterolateral aspects of the STT. 5,15,24 For this reason, bilateral destruction of the pain fibers from the lower trunk and extremities at the upper cervical level seems to be safer than ablation of the fibers from the upper trunk and upper extremities. 11,12 Kanpolat et al advise bilateral cordotomy only for cases with bilateral abdominal, pelvic, or lower extremity pain.…”

Percutaneous CT-guided cordotomy for the treatment of pediatric cancer pain

“…24 Bilateral high cervical cordotomy is not frequently practiced due to the risk of central hypoventilation syndrome or Ondine's curse. 1,2,7,9,13,16,17,20 The initial studies of percutaneous cordotomy were performed using fluoroscopic guidance. Although the pro cedures were effective in achieving pain reduction, 4 there was a significant risk of motor complications (0%-15% for unilateral and 12%-39% for bilateral procedures).…”