Cingulotomy for Intractable Pain

Abstract

Chronic pain is a common and often debilitating condition. This pain can be intractable to pharmacologic treatment, thereby necessitating non-pharmacologic approaches. Here we review anterior cingulotomy as a surgical solution to intractable chronic pain, from assessment and planning through the procedure and aftercare. Ablating tissue within the anterior cingulate cortex may allow for the amelioration of the affective aspect of chronic pain. This is especially beneficial to patients with significant psychiatric components to their pain, patients who are unfit for neuromodulatory implants, and patients with terminal diagnoses. Anterior cingulotomy is irreversible and is less commonly used than reversible neuromodulatory approaches. However, anterior cingulotomy remains an important option for patients suffering from intractable chronic pain.