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Temporal Summation Predicts De Novo Contralateral Pain After Cordotomy in Patients With Refractory Cancer Pain.
Treister, Roi; Honigman, Liat; Berger, Assaf; Cohen, Ben; Asaad, Israa; Kuperman, Pora; Tellem, Rotem; Hochberg, Uri; Strauss, Ido.
Afiliação
  • Treister R; Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
  • Honigman L; Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
  • Berger A; Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
  • Cohen B; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Asaad I; Institute of Pain Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
  • Kuperman P; Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
  • Tellem R; Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
  • Hochberg U; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Strauss I; The Palliative Medicine Care Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Neurosurgery ; 90(1): 59-65, 2022 01 01.
Article em En | MEDLINE | ID: mdl-34982871
BACKGROUND: Percutaneous cervical cordotomy (PCC), which selectively interrupts ascending nociceptive pathways in the spinal cord, can mitigate severe refractory cancer pain. It has an impressive success rate, with most patients emerging pain-free. Aside from the usual complications of neurosurgical procedures, the risks of PCC include development of contralateral pain, which is less understood. OBJECTIVE: To evaluate whether sensory and pain sensitivity, as measured by quantitative sensory testing (QST), are associated with PCC clinical outcomes. METHODS: Fourteen palliative care cancer patients with severe chronic refractory pain limited mainly to one side of the body underwent comprehensive quantitative sensory testing assessment pre-PPC and post-PCC. They were also queried about maximal pain during the 24 h precordotomy (0-10 numerical pain scale). RESULTS: All 14 patients reported reduced pain postcordotomy, with 7 reporting complete resolution. Four patients reported de novo contralateral pain. Reduced sensitivity in sensory and pain thresholds to heat and mechanical stimuli was recorded on the operated side (P = .028). Sensitivity to mechanical pressure increased on the unaffected side (P = .023), whereas other sensory thresholds were unchanged. The presurgical temporal summation values predicted postoperative contralateral pain (r = 0.582, P = .037). CONCLUSION: The development of contralateral pain in patients postcordotomy for cancer pain might be due to central sensitization. Temporal summation could serve as a potential screening tool to identify those who are most likely at risk to develop contralateral pain. Analysis of PCC affords a unique opportunity to investigate how a specific lesion to the nociceptive system affects pain processes.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor Intratável / Dor do Câncer / Neoplasias Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Neurosurgery Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Israel País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor Intratável / Dor do Câncer / Neoplasias Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Neurosurgery Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Israel País de publicação: Estados Unidos