Cingulotomy is a neurosurgical procedure that is used to treat a variety of debilitating diseases, including chronic pain. It was first developed in the 1960’s and has been studied extensively since that time. Over the past decades, improvements in technology have made this procedure minimally invasive and safe.
Appropriate candidates for Cingulotomy are those patients for whom traditional medical and/or surgical therapies have been unsuccessful. Patients with pain related to stroke, cancer, and spinal cord injury tend to enjoy the greatest benefit. Generally, pain must have been present for a period of at least 6 months and multiple conventional therapies must have already been tried. Cingulotomy is a non-reversible procedure and is therefore reserved for those patients in whom all other options have been exhausted.
Modern Cingulotomy is most often performed using thermal energy or specialized laser systems. No large open incision is required and many patients are able to go home the following day. During the procedure, focused energy is used create small lesions in the anterior cingulate cortex, an area of the brain that is involved in the perception of chronic pain.
At Columbia, Cingulotomy is performed using a minimally invasive, FDA-approved laser system that allows surgeons to pinpoint the target brain region with extreme precision. The lesion is created using real-time MRI guidance, so that the surgeon can accurately monitor the lesion and control its size and shape. This unique method also minimizes the chance of damaging nearby normal brain structures.
Patients who receive benefit from this treatment report an improved quality of life and less preoccupation with their pain. Cingulotomy targets the “bothersome” aspect of pain. Although not all patients are completely pain free after the procedure, many report feeling less anxiety and less distress from the pain. Additionally, Cingulotomy has the potential to decrease the amount of pain medication required by the patient, and thereby reduce their side effects.
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