Pain practice : the official journal of World Institute of Pain · 2026
Awake Percutaneous Cervical Cordotomy in Patients With Cancer: A Technical Report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Pradhana Adinda P, Timmerman Hans, Klarenbeek Egbert J M, Verstraaten Martijn L, Stellema Ruud, Reyners Anna K L, Wolff André P
Аннотация
BACKGROUND: Percutaneous cervical cordotomy (PCC) is a minimally invasive radiofrequency procedure for intractable unilateral cancer pain. Commonly performed under conscious sedation, awake PCC enables real-time patient feedback, potentially improving targeting precision and expanding eligibility for patients in whom sedation poses risks.
METHOD AND TECHNIQUE: This article presents the structured protocol for awake PCC implemented at our center, including pre-procedural training, positioning, fluoroscopic guidance, impedance monitoring, sensory and motoric testing, lesioning strategy, and aftercare. The key principle is to create the smallest effective lesion, applied incrementally until spinothalamic tract disruption is confirmed.
DISCUSSION: In our experience, awake PCC enables precise targeting and has yielded up to 90% success in pain relief. The approach requires substantial preparation, including training for both patient and team to ensure cooperation, clear communication, and tolerance of brief intraoperative discomfort. Although these demands can be challenging, we have found awake PCC to be a safe and effective last-resort option for patients facing devastating pain.
CONCLUSION: This technical note provides a practical and stepwise approach to awake PCC. It may assist clinicians in adopting or refining the technique.
METHOD AND TECHNIQUE: This article presents the structured protocol for awake PCC implemented at our center, including pre-procedural training, positioning, fluoroscopic guidance, impedance monitoring, sensory and motoric testing, lesioning strategy, and aftercare. The key principle is to create the smallest effective lesion, applied incrementally until spinothalamic tract disruption is confirmed.
DISCUSSION: In our experience, awake PCC enables precise targeting and has yielded up to 90% success in pain relief. The approach requires substantial preparation, including training for both patient and team to ensure cooperation, clear communication, and tolerance of brief intraoperative discomfort. Although these demands can be challenging, we have found awake PCC to be a safe and effective last-resort option for patients facing devastating pain.
CONCLUSION: This technical note provides a practical and stepwise approach to awake PCC. It may assist clinicians in adopting or refining the technique.