chordotomy

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chordotomy

[kȯr′däd·ə·mē]
(medicine)
Surgical division of a spinal nerve tract to relieve severe intractable pain.
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Possible surgical therapies for managing complex pain Lesional procedures Neuromodulation Other * Dorsal root entry zone * Spinal cord * Intrathecal lesioning stimulation medical therapy * Peripheral nerve * Microvascular stimulation decompression * Dorsal rhizotomy * Dorsal root ganglionectomy * Motor cortex stimulation * Rhizolysis of nerve ganglion * Cranial nerve stimulation * Neurectomy * Deep brain stimulation * Stereotactic radiosurgery * Percutaneous radiofrequency gangliolysis * Mechanical balloon gangliolysis * Image-guided tractotomy and nucleotomy * Cordotomy * Midline myelotomy
Many options of treatment for oncologic pain have been tried in the recent past decades, but the most popularized is the cordotomy.
Many modalities of cordotomy may be employed: anterior transdiscal between C4-C5; endoscopic infra mastoid tip between C1-C2; percutaneous guided by fluoroscopy infra mastoid tip between C1-C2; percutaneous guided by CT infra mastoid tip between C1-C2; open cordotomy by means of laminectomy.
Cordotomy consists in the discontinuation of the spinothalamic tract in the anterolateral quadrant of the spinal cord (Figure 1) and aims to reduce the transference of nociceptive information in the dorsal horn of the grey matter of the spinal cord (CPME) for rostral units at the neural axis (21).
However Finck advocated endoscopic laser cordotomy for bilateral abductor palsy 17.
to rs or In theory, cordotomy can treat pain anywhere in the body wh co o body, depending on which part of the cord doctors operate on.
Kevin Bleasel studied the use of spinothalamic cordotomy, particularly for the management of unilateral lower limb pain of malignant origin.
Cordotomy affects the sense of temperature as well as pain, since the fibers travel together in the express route.
Besides cordotomy, surgery within the brain or spinal cord to relieve pain includes severing connections at major junctions in pain pathways, such as at the places where pain fibers cross from one side of the cord to the other, or destroying parts of important relay stations in the brain like the thalamus, an egg-shaped cluster of nerve cells near the center of the brain.
She then underwent right vocal cordotomy and excision of the right arytenoid vocal process.
Rest/relaxation Behavioral training/counseling Biofeedback Hypnosis and other relaxation techniques Stretching/exercise Heat/cold Electrical stimulation Massage/mobilization Oral medications (antidepressants and inflammatories to narcotic analgesics) Injectable medication at or near site of discomfort (joint-space, epidural, and intrathecal) Nerve blocks and denervation techniques including surgical (rhizotomy, cordotomy, etc.