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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 mo^{^a} 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 dysfunction^{^a} Hypotension, Horner syndrome, bladder dysfunction
Comfortable in supine position Orthopnea^{^a} Inability to be supine long enough to complete procedure
Note:—pO₂ indicates partial pressure of oxygen; ICP, intracranial pressure.
↵a Relative contraindication.