• Nicola Atkin, Kate A Jackson, and R Andrew Danks.
• Palliative Care Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
• J Pain Symptom Manage. 2010 May 1; 39 (5): 924-9.

AbstractAt least 10% of patients with cancer have pain that is refractory to systemic analgesics. For most of these patients, interventional techniques may be of benefit but are often not considered or are difficult to access. Of these techniques, spinal analgesia is most commonly used in Australia and the United Kingdom, and neurosurgical procedures, such as open cordotomy with sectioning of the spinothalamic tract, are rarely used. We describe a case illustrating the successful use of bilateral open thoracic cordotomy in a patient with refractory mixed nociceptive and neuropathic pain secondary to a lumbosacral tumor. We discuss the various interventional options and review the recent literature regarding the use of both percutaneous and open cordotomy for cancer pain.Copyright 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

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