Cordotomy in Oncology
The cordotomy is a pain treatment in which the pain conductive nerve is interrupted in the spinal cord. the interruption takes place at the opposite side of where the pain occurs, just below the ear. The treatment is performed under local anesthesia, so you can assess whether the interruption of nerve pathways to the right area occurs. The cordotomy is only performed with pain due to malignancy. After cordotomy, the feeling of pain in the treated area disappears, but also the sense of heat and cold. The motor nerves remain intact, so you are not paralyzed!
The cordotomy is performed with pain in a body part which is not adequately controlled your current medication.
Your doctor will treat the pain by blocking the nerve that is responsible for the pain. This is done by the controlled application of heat through a needle that is inserted with the help of fluoroscopy. This needle will be inserted, on the other side of where the pain occurs, at about the level of the neck, near the ear. In most cases, the pain is reduced immediately, and the pain medication will be adjusted accordingly.
Preparing for the treatment
You fast on the day of surgery, but you will take all your medication, as you normally would. This does not apply to blood thinners. This medication should not be taken, starting a few days before the surgery.
You’ll arrive at the hospital about an hour before the scheduled treatment time. You will be escorted to your private room, where you can change into a gown.
Then you will be brought to the treatment room, where you will then be put on your back on the operating table. Additionally, your head may be fixed to the table with a strap, because you can not make any sudden movements during surgery.
Beforehand an IV will be placed, which will provide first provide antibiotics, and later medication, during the procedure, making you calmer, and possibly doze a bit during the operation. You will also be connected to a monitor so that we can monitor your vitals during the surgery.
After disinfection you’ll get an anesthesia injection at the height of the neck near the ear. Thereafter, the needle will be positioned, with the help of fluoroscopy, until the proper nerve has been reached. This is checked with the injection of contrast fluid. This may be sensitive. Then, with the help of test currents, the position of the needle is checked. It is important that you indicate where you feel the currents. If the needle is in the right place, the heat treatment begins.
As a result, the nerve path is interrupted and, in most cases, the pain immediately disappears.
This treatment is considered an inpatient procedure and can not be performed at OCP Medical Center at The Fairmont Dubai. However, you will be treated as if you are a patient of OCP Medical Center; you will be treated by one of our own doctors, we will schedule your appointments and keep your medical file.
Please note that this information gives an impression of a treatment so you can prepare in advance.
When the treatment is finished, you are brought to the recovery room, where you’ll stay for a little while. A few checks are performed here, after which you can safely return to your private room.
A few points are important: Your doctor will, after a successful cordotomy, immediately adjust jour medication. Sometimes a temporarily drop in blood pressure occurs. You remain in bed during the first few hours after the procedure, preferably on your back, because of possible leakage of fluids from the spinal cord. This can cause headaches after the treatment. This usually disappears on its own, within a few days. lying flat, drinking a lot and a simple painkiller reduce the discomfort. When you get out of bed, you need to be prepared for some temporary loss of strength in your legs. This is because of the heat treatment, which causes some temporary swelling around the nerve bundle in the spinal cord. You should also take into account that urinating is sometimes a bit difficult. This is also due to the swelling caused by the heat treatment. Optionally, you can temporarily get a catheter to help with this.
On the side where the pain is located, after the treatment will not only the pain, but also the sense of temperature has disappeared. this means that you should be careful with picking up hot and cold objects, and that you wear tough shoes, because you don’t always feel the pain when you step in something.
After 6 months there is a small chance of the occurrence of a burning pain or discomfort in the initial pain area. Finally, it is wise to keep an eye on your temperature. With a temperature rising above 38 degrees Celsius, you should contact your doctor.
Introducing our Pain Specialist
Introducing our Pain Specialist
Dr, Henk van Driel
Dr. Henk van Driel is operating as an anesthesiologist in the field of chronic pain for more than 25 years. After having initiated the pain management department in the Amphia Hospital in The Netherlands, the largest in the country, he opened Optimal Care Pijnklinieken back in 2008, the first clinic to offer the full range of pain management procedures available in The Netherlands.
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