Gamma knife radiosurgery (GKRS) for non-cancer refractory pain: early results of a single center series
EANS Academy. Picozzi P. Sep 26, 2019; 276059; EP07026
Dr. Piero Picozzi
Dr. Piero Picozzi

Access to this content is reserved for EANS members and attendees of this event. Click here to become an EANS member and gain your access to the full content of the EANS Academy

Discussion Forum (0)
Rate & Comment (0)
Objective: Thalamotomy for refractory neuropathic pain is an old procedure with recent revival due to the use of MRgFUS. GKRS has also been used since its origin to target sensory thalamus. We are presenting our initial experience in treating refractory pain with GKRS thalamotomy.
Methods: Between 2015 and 2018 8 patients (4m 4F mean age 47,5; range 43-83) were treated with GKRS for neuropathic pain: 4 patients suffered from neuropathic deafferentation trigeminal pain, 2 from brachial plexus avulsion, 2 from post herpetic neuralgia. All patients were submitted to mono or bilateral central lateral thalamotomy (CLT). 140 Gy at 100% isodose with single 4 mm shot (110° or 90° ) were delivered on the Central Lateral nucleus of the thalamus. All patients were submitted to 4 tests (McGill, EuroQol5D, DN4, SF-36v2) before treatment and at 6, 12 and 24 months follow-up to assess type and intensity of the pain and the impact on quality of life.
Results: Patients complaining pain for brachial plexus avulsion were classified as responders in 1/2 cases, with significant change in the scores at FU. Patients complaining post deafferentation trigeminal pain were classified as responders in 3/4 cases, with significant change in scores and improvement in QOL. Patients suffering from post-herpetic neuralgic syndrome responded in both cases. We classified as 'responders' the ones reporting more than 30% positive change in questionnaire results. No adverse effect was observed in any patient.
Conclusion: In very selected patients Gamma Knife CLT could be a safe therapeutic alternative in refractory non-cancer related refractory pain. Further studies in larger series are required to assess efficacy, safety and durability of the treatment.
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.

Save Settings