Turkish Neurosurgery 2013 , Vol 23 , Num 1
CT-Guided Percutaneous Cordotomy for Intractable Pain in What is More than a Disease: Lung Malignancies
1President of the Turkish Academy of Sciences, Emeritus, Ankara University, Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey
2Pamukkale University, Faculty of Medicine, Department of Neurosurgery, Denizli, Turkey
3Graduate of Ankara University, Faculty of Medicine, Ankara, Turkey
DOI : 10.5137/1019-5149.JTN.6980-12.0 AIM: Lung cancer is the leading cause of cancer-related mortality worldwide. Pain is a common problem in these patients, yet inadequate or dissatisfactory management is prevalent.

MATERIAL and METHODS: Between 1987 and 2012, 224 patients with intractable pain were treated with computerized tomography (CT)- guided cordotomy. Among them, 210 had intractable pain due to malignancies. The majority of the cases were diagnosed as pulmonary malignancies (108 patients). Sixty-seven were pulmonary carcinoma, 26 mesothelioma and 15 Pancoast tumors.

RESULTS: After cordotomy, 98.13% of cancer patients reported initial pain relief. Minimum and maximum preoperative scores of the Karnofsky Performance Scale were 20 and 70, versus postoperative scores of 40 and 90 (p<0.001). The median preoperative VAS score was 8 (6-9). On the first postoperative day, the score dropped sharply to 0 (0-8) (p<0.001). In this selected series of 108 percutaneous cordotomy procedures, as well as in the total series of 224 patients, there was no mortality or major morbidity.

CONCLUSION: CT-guided percutaneous cordotomy is an effective procedure that should be used in the treatment of cancer-related pain problems. We suggest that cordotomy should be preferred as soon as possible in patients who fail to respond to the classic analgesic therapy. Keywords : Pulmonary carcinoma, Mesothelioma, Pain

Corresponding author : Yucel Kanpolat, kanpolat@ada.net.tr