Cordotomy is a surgical procedure in which specific nerves within the spinal cord are severed to relieve severe, chronic pain, typically in patients with cancer or other conditions that cause intractable pain. The procedure is most often performed on the spinothalamic tract, which transmits pain signals to the brain, with the goal of reducing or eliminating the sensation of pain in certain parts of the body. Cordotomy can be performed on one side of the spinal cord (unilateral) or, in rare cases, on both sides (bilateral), depending on the location and intensity of the pain. The procedure is usually done using a needle or an electrode under local anesthesia or mild sedation, often guided by imaging techniques like CT scans. By targeting the precise area of the spinal cord responsible for transmitting pain signals, cordotomy can offer significant pain relief for patients who have not responded to conventional treatments such as medication or radiation therapy. However, cordotomy carries certain risks and potential complications. Common complications include weakness or numbness in areas of the body corresponding to the nerve pathways that are severed. Other risks involve loss of bladder or bowel control, respiratory issues (especially if the procedure is done in the cervical spine), or sensory disturbances like tingling or burning sensations. In some cases, pain may return after a period of relief. Post-operative care focuses on managing any new symptoms and ensuring the patient receives adequate rehabilitation and follow-up care to monitor for long-term effects.
