| Combined Treatment with Lumbar Sympathectomy and Cervical Cordotomy for Unilateral Cancer-Related Pain in Pelvic Cavity |
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Gang-Hyuk Park, Tae-Kyu Lee, Jong-Hyun Kim, Sang-Bok Lee, Do-Sung Yoo, Pil-Woo Huh, Kyung-Souk Cho |
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Department of Neurosurgery, Uijeongbu St Mary's Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, Korea |
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| Abstract |
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Cancer-related pain in pelvic cavity may be a severe symptom from metastatic cancer. Various treatments were described in the literature include systemic medications, epidural medications, or even sacral neurolectomies. We present 2 patients who have suffered from unilateral pain syndrome either from invasion of pelvic cavity or from rectal cancer and cervix cancer. For each patient, we describe the usefulness of lumbar sympathectomy and Percutaneous Cervical Cordotomy (PCC) to treat the unilateral pain syndrome successfully. Each procedure was performed with fluoroscopic guidance (both AP and lateral views) with the use of iodine contrast (Omnipaque-180) to confirm the location of the medication and its resulting spread. Then, the introduction of radiofrequency coagulation has made it possible to perform this procedure percutaneously. Both of the patients had a reduction in the frequency and intensity of unilateral pain, and no recurrence for up to 2months. Lumbar sympathectomy and PCC could be a useful treatment for unilateral pain syndrome in the oncologic population. Based on these findings, we feel that the branches of the sympathetic nerve set at L2 and spinothalamic track at C2 may be a good target for neurolytic procedures, such as radiofrequency ablation, for treatment of cancer-related pain in pelvic cavity. Further research is needed to determine the efficacy of this technique for the treatment of cancer-related pain in pelvic cavity in the oncologic population. |
| Key Words:
Cancer pain, Sympathectomy, Cordotomy. |
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