Bilateral anterior cingulotomy with Gamma Knife radiosurgery: Another alternative for the treatment of non-oncologic intractable chronic pain
Oscar I. Molina-Romero, Juan Carlos Diez Palma, Andrés Fonnegra Caballero, Andrés Segura-Hernandez, Juan P. Leal-Isaza and Julio R. Fonnegra Pardo
According to the International Association for the Study of Pain (IASP), pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage (1). Pain is the main reason for consulting health services and its chronic form is among the leading causes of years lost to disability (2)(3). The quality of life of patients with chronic pain can be severely affected not only by its sensitive component, transmitted through the spinothalamic pathway but by other components that can contribute to the disability generated due to pain, such as cognitive, behavioral, and emotional, which are conducted and processed by other pathways and structures. The anterior cingulate cortex has a critical role in pain processing, mainly in the emotional meaning of pain (4). In the literature, cases of ablative management in the cingulum through stereotactic surgery have been reported for the management of intractable chronic pain (ICP). Our objective is to describe the results of 5 cases with ICP which were treated with bilateral anterior cingulotomy through Gamma Knife radiosurgery (GKR). To our knowledge, no previous reports have described this technique in patients with ICP.
Keywords: Bilateral anterior cingulotomy, Gamma Knife radiosurgery, stereotactic radiosurgery, intractable chronic pain