Open thoracic anterolateral cordotomy for pain relief in children: report of 2 cases

Abstract

<jats:p>Open anterolateral cordotomy is an effective treatment option for adults with intractable pain, but it has seldom been attempted in children. In the 2 previously reported cases in children, the procedure was used within 10 days of death from neoplastic disease. In this paper the authors describe 2 cases in which open cordotomy was used successfully in children outside the immediate terminal phase of disease. Both patients experienced effective analgesia with minimal adverse effects. The authors propose that consideration of cordotomy as an option for the management of intractable pain in children does not need to be delayed until death is imminent.</jats:p>

Cervical Cordotomy in Terminal Cancer: Pain Relieving in Oncological Treatment

“…In addition, in most cases, a significant reduction in opioid dose was observed after the cordotomy. 9,[29][30][31][32][33][34][35][36] On second analysis, in the literature review, similar results are achieved: cordotomy results in immediate pain relief in 69 to 100% of the cases. 6 The surgery cannot be completed in 5.4% of the cases.…”

“…Another detail that was commented is that if cordotomy is performed in children, the surgeon should not expect the same result as that of the one made in adults. 30 According to Kanpolat, in 2009, patients may be evaluated in four groups postoperatively: Grade Ino pain; Grade IIpartial satisfactory pain relief; Grade IIIpartial non satisfactory pain relief; Grade IVno change in pain. Grades I and II were accepted as successful outcome and grades III and IV as unsuccessful.…”

“…►Table 1 shows these results according to each article researched. 9,[29][30][31][32][33][34][35][36]…”

“…Table ofarticles for updating the literature review from the procedure of cordotomy9,[24][25][26][27][28][29][30][31] …”

Somatotopic organization of the human spinothalamic tract: in vivo computed tomography–guided mapping in awake patients undergoing cordotomy

“…Percutaneous cervical cordotomy soon eclipsed the open procedure although both are still performed today. 20 Kanpolat et al introduced CT-guided percutaneous cordotomy in 1989 (most surgeons had been using fluoroscopy previously). 10 This team in Ankara later reported being able to selectively eliminate pain in the arm or leg during a cervical cordotomy by aiming the electrode entry just anterior to the dentate (leg region) or further anteriorly (arm region), in keeping with the AP model.…”