Long-term efficacy of surgical cordotomy in intractable non-malignant pain.

Our results show that about 40% of patients who have cordotomies for non-malignant pain gain a prolonged and worthwhile period of relief, allowing a return to work and normal living. The available evidence, though scanty, suggests that the decline in the analgesic efficacy of cordotomy tends to 'plateau' with the passage of time, though the exact pattern of this change remains undefined. We conclude that, while the complication rate of cordotomy is undoubtedly high, and its effectiveness far from ideal, it may nevertheless have a place in the treatment of carefully selected patients with intractable pain due to non-malignant causes.