Subarachnoid neurolytic block (L5–S1) and unilateral percutaneous cervical cordotomy in the treatment of pain secondary to pelvic malignant disease

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Abstract
The immediate and long-term results of subarachnoid neurolytic block (L[lumbar]5-S[sacral]1) with 7.5%, 10% and 15% concentrations of phenol in glycerin and/or unilateral percutaneous cervical cordotomy was studied in 73 patients (follow-up in 56 patients) suffering from perineal, perineopelvisacral or pelvisacral pain secondary to malignant diseases of the pelvic cavity. Subarachnoid neurolytic block (L5-S1) produced satisfactory, long-lasting relief of perineal pain when the higher concentrations of phenol (10 and 15%) were used. The only sequela reported was urinary retention. Percutaneous cervical cordotomy used for the treatment of pelvisacral or predominantly unilateral perineal pain gave complete pain relief until death in 76.7% of patients, either alone (36.7%) or in conjunction with pharmacological therapy (40%). Respective indications were established for the 2 procedures and cases in which their use may be complementary were identified.