[Percutaneous cervical chordotomy].
Andreas Kühner
Abstract
Andreas Kühner
Abstract
On the base of 52 percutaneous and 25 open cervical cordotomies, the technique, results and complications of the former are described in detail. The comparaisons of the results and complications shows that both methods are equals. 92,5% of excellent and good early results by percutaneous and 96% by open cordotomy were obtained. The longterm results of about 60% of good results for both methods are concordant to the litterature. Percutaneous cordotomy seems to give more stable analgesic levels. The complications and their mechanisms are discussed in detail and the dangers of high cervical cordotomies, even unilaterals, are outlined. The special risks of bilateral operations in which mortality is twice as high are shown. It is concluded that percutaneous cordotomy is as effective and secure as the open procedures but less aggressive. By this method even poor-risk patients can be treated. The fact that one is limited to a high cervical level represents a real disadvantage, so that classic techniques still have their indications.
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On the base of 52 percutaneous and 25 open cervical cordotomies, the technique, results and complications of the former are described in detail. The comparaisons of the results and complications shows that both methods are equals. 92,5% of excellent and good early results by percutaneous and 96% by open cordotomy were obtained. The longterm results of about 60% of good results for both methods are concordant to the litterature. Percutaneous cordotomy seems to give more stable analgesic levels. The complications and their mechanisms are discussed in detail and the dangers of high cervical cordotomies, even unilaterals, are outlined. The special risks of bilateral operations in which mortality is twice as high are shown. It is concluded that percutaneous cordotomy is as effective and secure as the open procedures but less aggressive. By this method even poor-risk patients can be treated. The fact that one is limited to a high cervical level represents a real disadvantage, so that classic techniques still have their indications.
Key concepts: Cordotomy, Percutaneous, Medicine, Surgery, Spinal cord, Psychiatry