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Ann Thorac Surg 1989;48:820-823
© 1989 The Society of Thoracic Surgeons

Articles

Modified open thoracic rhizotomy for treatment of intractable chest wall pain of malignant etiology

Ehud Arbit, MD*, Joseph H. Galicich, MD, Michael Burt, MD, Kasargod Mallya, MD

Neurosurgery Service and Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

Accepted for publication August 25, 1989.

* Address reprint requests to Dr Arbit, 1275 York Ave, New York, NY 10021.

We describe the surgical technique of modified open thoracic rhizotomy for treatment of intractable chest wall pain of malignant etiology. In a series of 14 patients, 9 (64%) had an excellent result, 4 (29%) had a good result, and 1 (7%) had a poor result. Successful palliation was made possible by identification with computed tomographic scan or magnetic resonance imaging of the nerve roots involved. Pain control lasted in most patients until death (median, 22 weeks; range, 6 to 45 weeks). The extrathecal procedure described has certain advantages over intndural transection of nerve roots. Indications for performing this procedu re are discussed along with other therapeutic options.




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