{"title":"Drezotomy and myelotomy for cancer pain.","authors":"Patrick Mertens, Andréi Brinzeu","doi":"10.1159/000548703","DOIUrl":null,"url":null,"abstract":"<p><p>Background When conservative treatment, including intrathecal infusion of pharmacological agents, or even multimodal therapies are not sufficiently effective, if their respective benefits-risks balances are favorable, Drezotomy and myelotomy, ablative surgeries targeting sensory circuits in the spinal cord, may still have a place today for well selected patients. Summary In this review article, the rationale and technical principles and their current potential indications, based on their results published, are described. Drezotomy have been reported effective for topographically limited cancer pain caused by well-localized lesion, in particular if nociceptive and neuropathic components are combined. Currently, the open punctate midline myelotomy is used for patients with intractable visceral cancer pain, abdominal or pelvic, even bilateral. For patients with limited survival, percutaneous myelotomy is recommended, given the less invasive nature of the procedure. However, the technique chosen for myelotomy will ultimately depend on the surgeon's experience and expertise. Key messages In spite of data coming only from case series, DREZotomy and myelotomy, that are technically demanding procedures, can be still useful interventions and discussed for well selected patients suffering from intractable cancer pain.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-19"},"PeriodicalIF":2.4000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Stereotactic and Functional Neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000548703","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROIMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Background When conservative treatment, including intrathecal infusion of pharmacological agents, or even multimodal therapies are not sufficiently effective, if their respective benefits-risks balances are favorable, Drezotomy and myelotomy, ablative surgeries targeting sensory circuits in the spinal cord, may still have a place today for well selected patients. Summary In this review article, the rationale and technical principles and their current potential indications, based on their results published, are described. Drezotomy have been reported effective for topographically limited cancer pain caused by well-localized lesion, in particular if nociceptive and neuropathic components are combined. Currently, the open punctate midline myelotomy is used for patients with intractable visceral cancer pain, abdominal or pelvic, even bilateral. For patients with limited survival, percutaneous myelotomy is recommended, given the less invasive nature of the procedure. However, the technique chosen for myelotomy will ultimately depend on the surgeon's experience and expertise. Key messages In spite of data coming only from case series, DREZotomy and myelotomy, that are technically demanding procedures, can be still useful interventions and discussed for well selected patients suffering from intractable cancer pain.
期刊介绍:
''Stereotactic and Functional Neurosurgery'' provides a single source for the reader to keep abreast of developments in the most rapidly advancing subspecialty within neurosurgery. Technological advances in computer-assisted surgery, robotics, imaging and neurophysiology are being applied to clinical problems with ever-increasing rapidity in stereotaxis more than any other field, providing opportunities for new approaches to surgical and radiotherapeutic management of diseases of the brain, spinal cord, and spine. Issues feature advances in the use of deep-brain stimulation, imaging-guided techniques in stereotactic biopsy and craniotomy, stereotactic radiosurgery, and stereotactically implanted and guided radiotherapeutics and biologicals in the treatment of functional and movement disorders, brain tumors, and other diseases of the brain. Background information from basic science laboratories related to such clinical advances provides the reader with an overall perspective of this field. Proceedings and abstracts from many of the key international meetings furnish an overview of this specialty available nowhere else. ''Stereotactic and Functional Neurosurgery'' meets the information needs of both investigators and clinicians in this rapidly advancing field.