Summary of ideal patient for cordotomy, contraindications, and specific additional material risks to the procedure
| Ideal Patient | Contraindications | Additional Risk |
|---|---|---|
| Unilateral nociceptive pain from extremity | Bilateral upper extremity pathology | Ondine's curse (apnea during sleep) if bilateral ablation |
| pO2 > 80% on room air | Severe pulmonary dysfunction | Insufficient reserve to tolerate decreased function |
| Life expectancy between 3 and 12 mo | Survival <3 moa or >12 mo | Deafferentation pain ≥6 mo after procedure |
| Normal ICP | Intracranial metastasis and/or mass effect | Brain herniation during procedure |
| Absence of psychiatric comorbidities | Opiate dependence or emotional problems | Persistent pain control problems after cordotomy |
| Intact autonomic system | Sympathetic dysfunctiona | Hypotension, Horner syndrome, bladder dysfunction |
| Comfortable in supine position | Orthopneaa | Inability to be supine long enough to complete procedure |
Note:—pO2 indicates partial pressure of oxygen; ICP, intracranial pressure.
↵a Relative contraindication.